title: Management of adverse events and other practical considerations in patients receiving capecitabine (Xeloda).
abstract: As capecitabine (Xeloda) is converted to 5-FU within tumours it can produce 5-FU-like side effects. However, diarrhoea, stomatitis, nausea, alopecia and neutropenia are significantly less frequent than with i.v. 5-FU. Hand-foot syndrome (HFS) is the only clinical adverse event occurring more often during capecitabine treatment. These findings in MCRC have also been confirmed in a large phase III trial in early stage colon cancer (X-Act adjuvant study) and phase II clinical trials in metastatic breast cancer. Because capecitabine is taken in the outpatient setting, the nurse and/or supervising clinician are responsible for educating patients how to use it correctly and on the nature/recognition/severity of adverse events. Patients need to be aware that temporary interruptions/dose modifications do not reduce the overall efficacy of capecitabine and will most likely lead to a resolution of side effects. Consequently, oncology nurses will be assuming a more significant and pivotal role in the efficient education and support of patients during home-based therapy with capecitabine.
authors.affiliation: University Hospital Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium. hilde.marse@uz.kuleuven.ac.be
authors.forename: Hilde
authors.initials: H
authors.lastname: Marsé
authors.forename: Eric
authors.initials: E
authors.lastname: Van Cutsem
authors.forename: Axel
authors.initials: A
authors.lastname: Grothey
authors.forename: Sonia
authors.initials: S
authors.lastname: Valverde
mesh_terms: D000505:Alopecia / Q000139:chemically induced; D000553:Ambulatory Care; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000451:nursing*; D000069287:Capecitabine; D003110:Colonic Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000451:nursing*; D003841:Deoxycytidine / Q000008:administration & dosage / Q000009:adverse effects* / Q000031:analogs & derivatives*; D003967:Diarrhea / Q000139:chemically induced; D004334:Drug Administration Schedule; D016903:Drug Monitoring; D005472:Fluorouracil / Q000031:analogs & derivatives; D006699:Home Care Services; D006801:Humans; D009325:Nausea / Q000139:chemically induced; D009503:Neutropenia / Q000139:chemically induced; D024802:Nurse's Role; D009859:Oncology Nursing / Q000458:organization & administration; D010353:Patient Education as Topic; D012449:Safety; D013280:Stomatitis / Q000139:chemically induced; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000964:Antimetabolites, Antineoplastic; D003841:Deoxycytidine; D000069287:Capecitabine; D005472:Fluorouracil