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.