대장암환자에서 Capecitabine (XelodaⓇ) 단독요법에 의한 수족증후군 (Hand-foot Syndrome Following Capecitabine (XelodaⓇ) Monotherapy for Colorectal Cancer)

서지정보

· 발행기관 : 대한대장항문학회
· 수록지 정보 : Annals of Coloproctolgy / 25권 / 4호 / 227 ~ 233페이지
· 저자명 : 박순도, 이길연, 박선진, 이석환, 이상목

초록

Purpose: Capecitabine (XelodaⓇ), which is a systemic prodrug of 5-fluorouracil, can be used in oral formulation for treatment
of advanced colorectal cancer as a 1st line or an alternative modality to I.V. 5-fluorouracil-based chemotherapy. One of the
most common side effects of this drug is hand-foot syndrome (HFS), palmar-plantar erythrodysesthesia syndrome. We planned
this study to clarify the incidence and the clinical course of severe hand-foot syndrome (WHO classification, grade 3 or 4)
following capecitabine monotherapy for adjuvant treatment of colorectal cancer.
Methods: From August 2006 to August 2008, 45 colorectal cancer patients were treated with capecitabine, 1,250 mg/m2,
orally administered twice daily for 2 wk, followed by 1 wk of rest, given as 3-wk cycles. Seven of them discontinued the drug
within 3rd cycle due to poor performance status, gastrointestinal troubles, or other causes. We retrospectively analyzed the
remaining 38 patients’ medical records and defined the incidence and the clinical course of HFS.
Results: Of the 38 patients, 17 (44.7%) suffered severe HFS after capecitabine monotherapy. Of those 17, 5 (29.4%) had
severe symptoms after the 1st chemotherapy cycle, and 14 patients (82.4%) had severe symptoms within the 4th cycle.
Three of the 14 female and 14 of the 24 male patients complained of severe HFS, showing a statistical male predominance (P=
0.043). Eventually, we had to decrease capecitabine to 75% of the daily dose in 12 patients and to 50% in one patient, and
to discontinue its use in 4 patients.
Conclusion: Capecitabine monotherapy very frequently provokes severe HFS, especially in the early cycles of chemotherapy
and in males.

영어초록

Purpose: Capecitabine (XelodaⓇ), which is a systemic prodrug of 5-fluorouracil, can be used in oral formulation for treatment
of advanced colorectal cancer as a 1st line or an alternative modality to I.V. 5-fluorouracil-based chemotherapy. One of the
most common side effects of this drug is hand-foot syndrome (HFS), palmar-plantar erythrodysesthesia syndrome. We planned
this study to clarify the incidence and the clinical course of severe hand-foot syndrome (WHO classification, grade 3 or 4)
following capecitabine monotherapy for adjuvant treatment of colorectal cancer.
Methods: From August 2006 to August 2008, 45 colorectal cancer patients were treated with capecitabine, 1,250 mg/m2,
orally administered twice daily for 2 wk, followed by 1 wk of rest, given as 3-wk cycles. Seven of them discontinued the drug
within 3rd cycle due to poor performance status, gastrointestinal troubles, or other causes. We retrospectively analyzed the
remaining 38 patients’ medical records and defined the incidence and the clinical course of HFS.
Results: Of the 38 patients, 17 (44.7%) suffered severe HFS after capecitabine monotherapy. Of those 17, 5 (29.4%) had
severe symptoms after the 1st chemotherapy cycle, and 14 patients (82.4%) had severe symptoms within the 4th cycle.
Three of the 14 female and 14 of the 24 male patients complained of severe HFS, showing a statistical male predominance (P=
0.043). Eventually, we had to decrease capecitabine to 75% of the daily dose in 12 patients and to 50% in one patient, and
to discontinue its use in 4 patients.
Conclusion: Capecitabine monotherapy very frequently provokes severe HFS, especially in the early cycles of chemotherapy
and in males.

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