Abstract
BackgroundHand-foot syndrome (HFS) is a side effect of skin related to pegylated liposomal doxorubicin (PLD) application. Moderate to severe hand-foot syndrome (MSHFS) might have a serious impact on patients’ quality of life and treatment. However, information on risk factors for the development of MSHFS is still limited. To analyze the risk factors for PLD-induced MSHFS in breast cancer patients and constructed a logistic regression prediction model.MethodsWe conducted a retrospective analysis of breast cancer patients who were treated with a PLD regimen in the Tumor Hospital of Harbin Medical University from January 2017 to August 2019. A total of 26 factors were collected from electronic medical records. Patients were divided into MSHFS (HFS > grade 1) and NMHFS (HFS ≤ grade 1) groups according to the NCI classification. Statistical analysis of these factors and the construction of a logistic regression prediction model based on risk factors.ResultsA total of 44.7% (206/461) of patients developed MSHFS. The BMI, dose intensity, and baseline Alanine aminotransferase (ALT) and Aspartate aminotransferase (AST) levels in the MSHFS group, as well as good peripheral blood circulation, excessive sweat excretion, history of gallstones, and tumour- and HER2-positive percentages, were all higher than those in the NMHFS group (P < 0.05). The model for predicting the occurrence of MSHFS was P = 1/1 + exp. (11.138–0.110*BMI-0.234*dose intensity-0.018*baseline ALT+ 0.025*baseline AST-1.225*gallstone history-0.681* peripheral blood circulation-1.073*sweat excretion-0.364*with or without tumor-0.680*HER-2). The accuracy of the model was 72.5%, AUC = 0.791, and Hosmer-Lemeshow fit test P = 0.114 > 0.05.ConclusionsNearly half of the patients developed MSHFS. The constructed prediction model may be valuable for predicting the occurrence of MSHFS in patients.
Highlights
Hand-foot syndrome (HFS) is a side effect of skin related to pegylated liposomal doxorubicin (PLD) application
Estrogen receptor (ER) was positive in 307 cases and negative in 157 cases, Progesterone receptor (PR) was positive in 266 cases and negative in 195 cases, Human epidermalgrowth factor receptor2 (HER2) was positive in 112 cases and negative in 349 cases, and there was high expression of Ki67 in 301 cases and low expression in 160 cases
All patients showed no cardiotoxicity. 12 patients discontinued PLD chemotherapy due to Moderate to severe hand-foot syndrome (MSHFS) and switched to adriamycin combined with cyclophosphamide chemotherapy
Summary
Hand-foot syndrome (HFS) is a side effect of skin related to pegylated liposomal doxorubicin (PLD) application. To analyze the risk factors for PLD-induced MSHFS in breast cancer patients and constructed a logistic regression prediction model. Breast cancer is the most prevalent malignancy in women worldwide [1]. Systemic chemotherapy is still a common method of treating breast cancer. Anthracyclines, such as doxorubicin, represent one of the dominant therapeutic drugs [3]. To reduce the side effects of anthracyclines and improve their efficacy, several studies have been carried out to find new strategies to maximize clinical efficacy and to simultaneously control the side effects of doxorubicin [5]. With the increasingly wide application of PLD in the clinic, the number of side effects of PLDrelated chemotherapy for HFS has increased
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