Abstract: Objective To compare the effects of medical ozone oil and urea ointment for prevention and treatment of hand-foot skin reaction (HFSR) caused by sorafenib in patients with hepatocellular carcinoma (HCC). Methods A total of 99 patients diagnosed with advanced HCC according to National Comprehensive Cancer Network (NCCN) who were scheduled to receive sorafenib treatment for the first time were enrolled in this study between April, 2018 and January, 2020. The patients were randomized into medical ozone oil group (n=49) and urea ointment group (control group, n=49) for treatment with local application of 1 mL medical ozone oil (experimental group) and 10% urea ointment (2 g) on the palm and plantar skin
(including the fingers and joints) for 12 weeks (3 times per day) starting at the beginning of sorafenib treatment, respectively.
The patients were observed for occurrence of HFSR every 2 weeks for 14 weeks. Results Eight patients were excluded for poor
compliance or protocol violations, leaving a total of 91 patients for analysis, including 44 in medical ozone oil group and 47 in
urea ointment group. Sixteen (36.4%) of patients in ozone oil group developed HFSR, a rate significantly lower than that in
urea ointment group (57.4%; P<0.05). The incidence of grade 2/3 HFSR was also lower in ozone oil group than in urea ointment
group (15.9% [7/44] vs 27.7 [13/47]). Conclusion Medical ozone oil can significantly reduce the incidence and severity of HFSR
to improve the quality of life of HCC patients receiving sorafenib treatment.

Key words: nursing intervention, ozone oil, sorafenib, hand-foot skin reaction, advanced hepatocellular carcinoma