title: [Adverse events in patients treated with capecitabine as adjuvant chemotherapy after surgery for colorectal cancer--countermeasures against hand-foot syndrome].
abstract: 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.
authors.affiliation: Dept. of Gastroenterological Surgery, Yamagata Prefectural Central Hospital, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Suto
authors.forename: Koushiro
authors.initials: K
authors.lastname: Ishiyama
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yabuki
authors.forename: Naoki
authors.initials: N
authors.lastname: Mori
authors.forename: Koetsu
authors.initials: K
authors.lastname: Inoue
authors.forename: Masato
authors.initials: M
authors.lastname: Chiba
authors.forename: Akiko
authors.initials: A
authors.lastname: Igawa
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Watanabe
authors.forename: Hiroto
authors.initials: H
authors.lastname: Fujimoto
authors.forename: Yumi
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Makoto
authors.initials: M
authors.lastname: Sugawara
authors.forename: Tomomi
authors.initials: T
authors.lastname: Saito
authors.forename: Yuka
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: Mikiko
authors.initials: M
authors.lastname: Matsuda
authors.forename: Eiichi
authors.initials: E
authors.lastname: Ikeda
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Sato
authors.forename: Hajime
authors.initials: H
authors.lastname: Iizawa
mesh_terms: 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
chemical_list: D003841:Deoxycytidine; D000069287:Capecitabine; D005472:Fluorouracil