Management of cytotoxic chemotherapy-induced hand-foot syndrome

Abstract

Improvements in systemic cancer treatments have resulted in more patients surviving for prolonged periods of time on treatment. This has made treatment-related toxicity and quality of life concerns increasingly relevant. Hand-foot syndrome (HFS) is a common skin reaction to systemic therapy that should be anticipated with chemotherapeutic treatments such as pegylated liposomal doxorubicin, docetaxel, and fluoropyrimidines. In this review we discuss current knowledge of the diagnosis, incidence, pathogenesis, and management of hand-foot syndrome (HFS). Although HFS is not life threatening, it can cause significant discomfort and impairment of function, especially in elderly patients, and may seriously impact quality of life. The incidence of HFS is dependent on the chemotherapeutic drug used, the treatment schedule, and the median duration of treatment. Effective measures for prevention and treatment of HFS include systemic and topical treatments, dose reductions, and switching to other drugs in the same class that are associated with lower rates of HFS. These approaches allow patients to continue cancer treatment while reducing negative impacts on quality of life. Awareness and early recognition are important to ensure timely treatment and avoidance of dose reductions or treatment discontinuation. We provide useful recommendations to guide the management of HFS in clinical practice.

Preliminary Efficacy and Safety of Camrelizumab in Combination With XELOX Plus Bevacizumab or Regorafenib in Patients With Metastatic Colorectal Cancer: A Retrospective Study

“…Moreover, capecitabine-related hand-foot syndrome (HFS), one of the causes of the switch in three treatments, was in a regorafenib-containing regimen. HFS is a common skin reaction to capecitabine with rates of any grade, of 22%-77% (25).…”

“…Moreover, capecitabine-related hand-foot syndrome (HFS), one of the causes of the switch in three treatments, was in a regorafenib-containing regimen. HFS is a common skin reaction to capecitabine with rates of any grade, of 22%–77% ( 25 ). Similarly, regorafenib-associated hand-foot skin reactions occurred at a rate of 61% overall and 20% at grade 3 ( 26 , 27 ).…”

An Evaluation of the Diagnostic Accuracy of a Panel of Variants in DPYD and a Single Variant in ENOSF1 for Predicting Common Capecitabine Related Toxicities

“…The mechanism by which capecitabine causes HFS is not fully understood but it has been suggested that because there are higher levels of expression of Thymidine phosphorylase (TP) in the palms of the hands and the soles of the feet that a higher level of capecitabine metabolites accumulate here and lead to the symptoms of HFS [ 35 ]. Formulations of 5-FU that also include a DPD inhibitor such as S-1 (tegafur, 5-chloro-2,4-dihydroxypyridine (CDHP), potassium oxonate), uracil/tegafur (UFT) and eniluracil/5-FU treatment also have lower rates of HFS compared to capecitabine and infusional 5-FU [ 36 ].…”

A Simplified Overview of the Current Non-Surgical Treatment of Brain Tumor Patients with Special Emphasis on Its Complications. A Much Needed Contemporary Review Especially for Neurosurgeons

“…Commonly available medicine is used treat to treat adverse effects. 21 Before introduction of targeted therapy, surgery was performed to majority of giant cell astrocytoma. Currently, we have option of targeted therapies for recurrent tumors.…”