A Randomized Single-Blinded Phase II Trial Comparing Efficacy and Quality of Life of Topical Aloe Vera Gel Plus Urea Cream Versus Urea Cream Alone for Prevention of Hand Foot Syndrome in Cancer Patients Receiving Capecitabine.

INTRODUCTION: Capecitabine has been widely prescribed to treat various cancers. The hand foot syndrome (HFS) is the most troublesome adverse effect. Urea cream has been pre-emptively co-prescribed, even though its efficacy is doubtful. Aloe vera gel with urea cream might potentiate each other. This trial was intended to prove the efficacy of this combination. MATERIALS AND METHODS: The investigators conducted a randomized single-blinded phase II study. The participants were randomized 1:1 to receive the combination of aloe vera gel and 10% urea cream (n = 30), the experimental A+U arm and 10% urea cream alone (n = 31), the U arm. The sample size was calculated to have 90% power to show the significant 20% reduction in the incidence of HFS grade 2-3 of the combination therapy with alpha level = 0.05. Both the CTCAE criteria version 5 and the dermatology life quality index (DLQI) were assessed to determine the severity of HFS and quality of life, respectively. RESULTS: Most of the participants had rectal cancer (A+U: 43.3%; U: 41.9%). In the A+U group, 86.7% had grade 0-1 HFS and 13.3% had grade 2-3 HFS. In the U group, 64.5% had grade 0-1 HFS and 35.5% had grade 2-3 HFS (Mann-Whitney U test, p = 0.045). Grade 2-3 HFS was significantly lower in the combination group. CONCLUSION: Combination of aloe vera gel and 10% urea cream ameliorated the severity of HFS in participants taking capecitabine; however, no significant difference in DLQI between the groups was demonstrated.

Predictive Factors of Neutropenia in HIV-Infected Patients with Malignancy Receiving Chemotherapy or Radiotherapy.

OBJECTIVE: To determine the predictive factors of neutropenia in human immunodeficiency virus (HIV)-infected patients with malignancy receiving chemotherapy (CMT) or radiotherapy (RT). MATERIALS AND METHODS: The author conducted a retrospective study on HIV-infected patients with malignancy receiving CMT or RT at Vajira Hospital, Navamindradhiraj University, Thailand, from January 1, 2013 to December 31, 2017. Baseline demographic characteristics, HIV disease data, and cancer data were collected. RESULTS: A total of 210 courses of CMT, concurrent chemoradiation therapy (CCRT), or RT treatments were administered to 39 HIV-infected patients with malignancy. Neutropenia occurred in 51 (24.3%) of the 210 treatment courses in 23 (60%) patients. Multivariable analysis revealed that HIV-infected patients with malignancy who received CMT or CCRT (hazard ratio [HR] 10.83, 95% confidence interval [CI] 1.36-86.05, p = 0.024) and those who received over five cycles of CMT (HR 5.25, 95% CI 1.10-26.01, p = 0.037) were independently associated with neutropenia. CONCLUSION: Receiving CMT or CCRT and receiving more than five cycles of CMT are risk factors for neutropenia in HIV-infected patients with malignancy.