Background 

Hand-foot syndrome (HFS) is a specific adverse effect of certain chemotherapy that may lead to dosage reduction or chemotherapy discontinuation in patients with cancer. Topical urea cream may reduce symptom severity in patients with HFS. However, these studies have not provided consonant results.

Objective 

To determine the effectiveness of urea cream, we conducted a meta-analysis of clinical trials to evaluate the prevention and treatment of HFS.

Methods 

PubMed, EMBASE, and Cochrane Library databases were searched for studies published before September 2020. The study registered at PROSPERO (CRD 42020203164). Incidence of HFS reported in studies at any grade and at second grade or greater was assessed within 3 to 12 weeks. Secondary outcomes were time to HFS, incidence of skin-related adverse events, chemotherapy dose reduction, and quality of life.

Results 

Seven trials involving 1387 patients were reviewed. In the prophylactic subgroup, patients with urea cream intervention showed a significantly lower incidence of HFS at second grade or greater (risk ratio, 0.72; 95% confidence interval, 0.58-0.90) and a nonsignificant lower incidence of any-grade HFS (risk ratio, 0.79; 95% confidence interval, 0.58-1.08) than those not receiving urea cream intervention.

Conclusions 

Urea cream has advantages to reduce the incidence of severe HFS.

Implications for Practice 

Urea cream is a safe and viable topical prevention strategy that can reduce the incidence of high-grade HFS in patients undergoing chemotherapy. We recommend a routine treatment option before chemotherapy for the patients.

中文翻译：

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尿素霜对化疗患者手足综合征的影响：一项荟萃分析

背景 

手足综合征 (HFS) 是某些化疗的特定不良反应，可能导致癌症患者减少剂量或停止化疗。外用尿素乳膏可减轻 HFS 患者的症状严重程度。然而，这些研究并没有提供一致的结果。

客观的 

为了确定尿素霜的有效性，我们对临床试验进行了荟萃分析，以评估 HFS 的预防和治疗。

方法 

在 PubMed、EMBASE 和 Cochrane 图书馆数据库中搜索了 2020 年 9 月之前发表的研究。该研究在 PROSPERO (CRD 42020203164) 注册。在 3 至 12 周内评估了在任何年级和二年级或更高年级的研究中报告的 HFS 发生率。次要结果是 HFS 时间、皮肤相关不良事件的发生率、化疗剂量减少和生活质量。

结果 

审查了涉及 1387 名患者的七项试验。在预防性亚组中，使用尿素乳膏干预的患者在二级或更高级别的 HFS 发生率显着降低（风险比，0.72；95% 置信区间，0.58-0.90），任何级别的 HFS 发生率（风险比）均不显着降低。 , 0.79; 95% 置信区间, 0.58-1.08) 比没有接受尿素霜干预的人。

结论 

尿素霜具有降低严重HFS发生率的优势。

对实践的启示 

尿素霜是一种安全可行的局部预防策略，可以降低接受化疗的患者高级别 HFS 的发生率。我们建议患者在化疗前进行常规治疗。