Dados do Trabalho

Título

CAPECITABINE-RELATED HAND-FOOT SYNDROME (HFS): THE IMPORTANCE OF DERMATOLOGICAL ASSESSMENT IN ONCOLOGICAL PATIENTS

Introdução

The hand-foot syndrome (HFS) or palmoplantar erythrodysesthesia is characterized by erythema, edema and dysesthesia, which can progress to blistering and ulceration. This condition is described as a common adverse effect of capecitabine.

Objetivo

To evaluate a real-world incidence, severity and associated factors of HFS related to the use of capecitabine at a brazilian southeast university hospital.

Método

This is a single center prospective cohort of consecutive adult solid cancer patients who received capecitabine alone or in combination to oxaliplatin between October 2020 and May 2021. All participants were referred and had a three weeks scheduled visit to dermatology service for multidisciplinary care, safety data collection according to Common Terminology Criteria for Adverse Events (CTCAE). All patients received standardized orientations.

Resultado

From a total of 52 patients, 44 were eligible for analysis (6 excluded due non adherence to dermatology schedule visit and 2 for not using at least one cycle of capecitabine). Median age was 58 years old and 63% of participants were female. Most of patients had colorectal cancer (n=22 ; 50%) or breast cancer (n=16 ; 36%), used capecitabine as monotherapy (n=32 ; 73%) and the treatment with capecitabine had curative (adjuvant or neoadjuvant) intention (n=27 ; 61%). Overall, one of each three patients (n=15 ; 34%) was diagnosed with HFS symptoms related to capecitabine. Importantly, the vast majority of the patients with HFS were classified as mild (73,3%) defined as CTCAE grade 1. Of note, only three patients had grade 2 and only one had grade 3 symptoms. Regarding clinicalpathological mutivariable analysis related to HFS, only female sex (p=0,022) and ECOG-PS 2 or more (p<0.001) were statistical significant risk factors. There was no statistical relevance of the occurrence of HFS with the number of chemotherapy cycles, site of primary neoplasm and presence of metastasis

Conclusão

In this collaborative oncology and dermatology prospective cohort, we found a reduced overall incidence of HFS in comparison to literature and the vast majority of toxicities were graduated as mild. Our results are consonant and reinforce the importance of a routine dermatology multidisciplinary assessment for adequate care, early diagnosis and follow-up for prevention and management of HFS related to capecitabine.

Palavras-chave

Capecitabine, chemotherapy, hand-foot syndrome