Zhou, Y., Peng, L., Li, Y., & Chen, L. (2013). Prophylactic pyridoxine was not able to reduce the incidence of capecitabine-induced hand-foot syndrome: A meta-analysis. Biomedical Reports, 1, 873–878.

Purpose

STUDY PURPOSE: To review published literature on the effect of prophylactic pyridoxine on hand-foot syndrome (HFS)
 
TYPE OF STUDY: Meta-analysis and systematic review

Search Strategy

DATABASES USED: PubMed, Embase, Web of Science, the Cochrane Library, the American Society of Clinical Oncology (ASCO), and ASCO Gastrointestinal Cancers Symposium 
 
KEYWORDS: Capecitabine, Xeloda®, pyridoxine, vitamin B6, hand-foot syndrome, and palmar-plantar erythrodysesthesia
 
INCLUSION CRITERIA: Patients received chemotherapy that included capecitabine; trials included a treatment group receiving pyridoxine during chemotherapy and a control group that did not receive pyridoxine; and the evaluation of HFS in the published trials adopted the toxicity grading of the National Cancer Institute Common Toxicity Criteria.
 
EXCLUSION CRITERIA: Animal or in vitro studies, not primary studies, and duplicate publications of other studies previously identified

Literature Evaluated

TOTAL REFERENCES RETRIEVED: 51
 
EVALUATION METHOD AND COMMENTS ON LITERATURE USED: Studies were independently assessed by two reviewers, and relevant study information was retrieved by two independent reviewers using a standardized method. The authors did not use prespecified quality-related inclusion or exclusion criteria and did not assign quality scores to the studies used in the final analysis. 

Sample Characteristics

  • FINAL NUMBER STUDIES INCLUDED: 5 
  • TOTAL PATIENTS INCLUDED IN REVIEW = 793
  • KEY SAMPLE CHARACTERISTICS: Multiple types of cancer including colon, breast, stomach, biliary tract, and duodenum. Pyridoxine dose ranged from 50 mg/day to 600 mg/day.

Phase of Care and Clinical Applications

PHASE OF CARE: Active antitumor treatment

Results

Prophylactic pyridoxine did not reduce the incidence of capecitabine-induced HFS of any grade (OR = 0.91; 95% CI: 0.67–1.24), of ≥ grade 2 HFS (OR = 1.17; 95% CI: 0.82–1.67), or ≥ grade 3 HFS (OR = 1.05; 95% CI: 0.60–1.85).

Conclusions

Pyridoxine is not effective at preventing HFS associated with capecitabine.

Limitations

  • The dose of pyridoxine varied greatly from 50 mg/day to 600 mg/day.
  • The optimal dose of pyridoxine has not been established. 
  • Two included studies were retrospective studies. 
  • Authors noted a publication bias in severe HFS.

Nursing Implications

Prophylactic pyridoxine is not an effective intervention to prevent HFS in patients receiving capecitabine.

Legacy ID

4437