[Adverse events in patients treated with capecitabine as adjuvant chemotherapy after surgery for colorectal cancer--countermeasures against hand-foot syndrome].
Although the 2009 edition of the Guidelines for Colorectal Cancer Therapy recommend capecitabine as a standard postoperative adjuvant chemotherapy for colorectal cancer therapy, a characteristic adverse event, hand-foot syndrome, develops at a high incidence, and appropriate management is necessary to continue therapy. We investigated countermeasures against adverse events, particularly hand-foot syndrome, in patients treated with capecitabine. The subjects were 47 patients aged 64 years (27-84 years) who underwent surgery for colorectal cancer. They received 8 (2-16) courses of drug administration. No grade 3 blood or non-blood toxicity was noted, and the therapy was relatively safe excluding an enhanced anticoagulant effect. Grade-3 hand-foot syndrome developed in 3 patients, but there were only 10 grade-2/3 cases (21.7%) because humectants and oral vitamin B6 preparation (supportive therapy) were administered from therapy initiation. The incidence increased to 32.6% (15 patients) after June. Symptoms aggravated due to mechanical stimulation of the hands and legs in 5 patients because they were farmers growing cherries, suggesting that investigation of patient living background is also important. The incidence of grade-2/3 hand-foot syndrome was 21.1 and 75% in 39 and 8 patients, respectively, who were treated with supportive therapy from the initiation of drug administration and after several courses of drug administration or development of symptoms. This suggested the usefulness of early supportive therapy. The importance of preventive measures against hand-foot syndrome will increase as capecitabine is increasingly administered. Information exchange between medical staffs and providing patients with appropriate information may lead to management of adverse events and subsequently to continuation and obtaining effects of therapy.
Suto
Takeshi
T
Dept. of Gastroenterological Surgery, Yamagata Prefectural Central Hospital, Japan.
Ishiyama
Koushiro
K
Yabuki
Hiroshi
H
Mori
Naoki
N
Inoue
Koetsu
K
Chiba
Masato
M
Igawa
Akiko
A
Watanabe
Toshihiro
T
Fujimoto
Hiroto
H
Suzuki
Yumi
Y
Sugawara
Makoto
M
Saito
Tomomi
T
Kobayashi
Yuka
Y
Matsuda
Mikiko
M
Ikeda
Eiichi
E
Sato
Toshihiko
T
Iizawa
Hajime
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000069287:Capecitabine; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000601:surgery; D003841:Deoxycytidine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D004890:Erythema / Q000139:chemically induced* / Q000473:pathology; D005260:Female; D005472:Fluorouracil / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005528:Foot / Q000473:pathology; D006225:Hand / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged
D003841:Deoxycytidine; D000069287:Capecitabine; D005472:Fluorouracil