Integration of Ayurveda in managing chemotherapy-induced hand-foot-skin reaction-an exploratory quasi experimental study.

INTRODUCTION: Hand-foot-skin reaction (HFSR) is one of the major mucocutaneous adverse events of multi-kinase inhibitors (MKIs). Its overall incidence is 35.0%. It negatively impacts the quality of life of the patient and compliance with chemotherapy. Present management of HFSR is largely anecdotal, and the common treatment is dose regulation or discontinuation of chemotherapy. In Ayurveda, the clinical presentation of HFSR may be understood as pitta rakta-pradhana agantuja vraṇa in hasta and pada caused by MKIs. The present study aimed to evaluate the Ayurveda treatment protocol as an add-on to the standard of care. METHODOLOGY: This is a double-arm-controlled interventional study with a quasi-experimental design, registered in the Clinical Trial Registry of India under CTRI/2022/03/040929, with 22 participants from the Medical Oncology Department and Integrative Medicine, Amrita Institute of Medical Sciences, Kochi. The study group received an add-on treatment to the standard of care (SOC). This included Yasṭimadhu Kashaya pariseka (from days 1 to 30), followed by Satadhauta ghrita Lepana (from days 6 to 30) twice daily immediately after pariseka. A gap of 1 h was maintained between the Ayurveda treatment and SOC as prescribed by the oncologist. RESULTS AND CONCLUSION: The study group demonstrated a significant reduction in pain (VAS) and improvement in quality of life (HF-QoL) compared to the control group. Yasṭimadhu is vrana sandhaneeya, varnya, daha prashamana, shothahara, and shonitasthapana. Ghrita is Vata pittahara, sheeta veerya, and dahaprashamana, and it facilitates ropana. HF-QoL improved due to effective management of symptoms. The pilot study suggested that an integrated therapy is feasible in HFSR patients, which can possibly support improving the quality of life for cancer patients undergoing chemotherapy. CLINICAL TRIAL REGISTRATION: CTRI/2022/03/040929, https://www.ctri.nic.in/Clinicaltrials/pmaindet2.php?EncHid=NjMwMTE=&Enc=&userName=.