Evaluation of hand-foot syndrome in the use of capecitabine in the treatment of patients with advanced breast cancer
DOI:
https://doi.org/10.31877/on.2013.22.01Keywords:
hand-foot skin reaction (HFSR), capecitabine, quality of life, dermatological toxicity, breast cancer, DLQI, FDLQIAbstract
Hand-Foot Skin Reaction (HFSR) is a potentially debilitating toxicity side effect mainly associated with 5-FU, liposomal doxorubicin and capecitabine that may have implications in treatment effectiveness and patient quality of life (QoL).
In order to prevent secondary effects, it is imperative to evaluate incidence and severity of HFSR in breast cancer patients receiving oral capecitabine chemotherapy, and to assess the impact on the QoL of patients who experience HFSR and their families. This is of major importance of our practice to improve our patients and these families. Education and formation with new strategies will minimize problems caused by this practice. Prospective, non-interventional study. This study was made to 40 female patients with advanced breast cancer whom started palliative chemotherapy with oral monotherapy capecitabine. The education period made to catch patient treatment was of 3 month.
All treatments taken were made without any other agents chemotherapy or any other target therapy. Over a 3-month period, 40 female patients starting capecitabine chemotherapy as a treatment for breast cancer (cycles with 14 consecutive days of capecitabine treatment each, with a one week interval between them) were evaluated. Patient and patients’ family HFSR-related QoL was assessed, respectively, using Dermatology Life Quality Index (DLQI) and Family Dermatology Life Quality Index
(FDLQI) questionnaires. The family was also assessed since same palliative were not fully independent regarding their daily basics activities.
In the evaluation of toxicity dermatology / skin scale was used CTCAE – Version 3.0. Regarding the incidence and severity of HFSR, the study suggested a statistically significant decrease in the percentage of patients with grade 1 toxicity and an increase of toxicity grades 2 and 3, for both hands and feet skin changes and rash/desquamation; around 4% of the nail changes had grade 4 toxicity
from the 6th week on. The analysis of the impact of HFSR in QoL showed a significant increase over time of the DLQI scores, while the FDLQI remained constant.
The results of this gave us the perspective that patients connect follow went during the treatment
decreases the coetaneous toxicity of the HFSR.
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