title: Comparative assessment of skin and subcutaneous toxicity in patients of advanced colorectal carcinoma treated with different schedules of FOLFOX.
abstract: OBJECTIVE
  The study was designed to assess the skin and subcutaneous toxicity in patients with advanced colorectal carcinoma treated with four different schedules of FOLFOX.
  
  
  METHODS
  The patients with histologically confirmed advanced colorectal carcinoma (CRC) were included in the study as per specified inclusion criteria. Toxicity was graded according to CTC v2.0. The frequency of grade 3 and 4 adverse effects were comparatively assessed in each treatment arm.
  
  
  RESULTS
  Very severe toxicity was attributed to the FOLFOX7 schedule. The difference between the incidence rate of grade 4 toxicity with all other grades for all parameters of skin and subcutaneous toxicity was highly significant (p=0.00<0.001). Grade 4 hand and foot syndrome was reported only in the FOLFOX7 treatment arm. The most frequent adverse symptom of skin and subcutaneous toxicity reported in the patients treated with modified schedule of FOLFOX was pruritus (grade 1). Frequency and onset of skin and subcutaneous toxic symptoms like alopecia (p=0.000), nail discoloration (p=0.021) and pruritis (p=0.000) was significantly different in each FOLFOX treatment arm. A few cases of oncholysis were also reported in the FOLFOX7 treatment arm. Hand and foot syndrome was fast progressing in patients with grade 1 toxicity.
  
  
  CONCLUSIONS
  Higher frequency and severity of hand and foot syndrome and pruritus wasa found in the FOLFOX7 treatment arm. Skin and subcutaneous toxicity was comparatively low in the FOLFOX6 treatment arm.
authors.affiliation: Ziauddin University, Karachi, Pakistan. nusratbano@hotmail.com
authors.forename: Nusrat
authors.initials: N
authors.lastname: Bano
authors.forename: Rahila
authors.initials: R
authors.lastname: Najam
authors.forename: Ahmed
authors.initials: A
authors.lastname: Mateen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000505:Alopecia / Q000139:chemically induced* / Q000175:diagnosis; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D015179:Colorectal Neoplasms / Q000150:complications* / Q000188:drug therapy; D005260:Female; D005472:Fluorouracil / Q000009:adverse effects; D005500:Follow-Up Studies; D060831:Hand-Foot Syndrome / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D002955:Leucovorin / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009260:Nail Diseases / Q000139:chemically induced* / Q000175:diagnosis; D009944:Organoplatinum Compounds / Q000009:adverse effects; D011379:Prognosis; D011537:Pruritus / Q000139:chemically induced* / Q000175:diagnosis; D012871:Skin Diseases / Q000139:chemically induced* / Q000175:diagnosis; D018675:Toxicity Tests; D055815:Young Adult
chemical_list: D009944:Organoplatinum Compounds; D002955:Leucovorin; D005472:Fluorouracil