Hand-Foot Syndrome in Patients Treated With Capecitabine-Containing Combination Chemotherapy

Clinical characteristics and risk factors of hand‐foot syndrome were investigated in patients who received capecitabine‐containing chemotherapy. Toxicity data were analyzed from 179 patients in 4 prospective clinical trials testing docetaxel/capecitabine/cisplatin in stomach cancer, capecitabine/cisplatin in biliary or stomach cancer, and vinorelbine/capecitabine in breast cancer. Hand‐foot syndrome was reported in 116/179 (64.8%) of patients, with grade 3 hand‐foot syndrome in 8/179 (4.5%). Hand‐foot syndrome first developed within the first 3 chemotherapy cycles in 100/116 (86.2%) patients, with the median onset for all 3 treatment regimens occurring during cycle 2. Because severe reactions were rare, hand‐foot syndrome was not a major factor influencing treatment schedule. Risk factor analyses showed that combined use of docetaxel and preceding chemotherapy‐related stomatitis were significant risk factors for the develop‐ ment of hand‐foot syndrome. Our results suggest that a combined treatment agent and a patient's susceptibility to chemotherapy‐related toxicity may increase the risk of capecitabine‐induced hand‐foot syndrome.