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Abstract：
BACKGROUND: Hand-foot syndrome (HFS) significantly impacts quality of life in cancer patients undergoing capecitabine treatment. This study assessed capecitabine-associated HFS prevalence, its impacts on chemotherapy treatment, and identified risk factors in multiracial Malaysian patients.
METHODS: We included adult cancer patients receiving capecitabine at Sarawak General Hospital for at least two cycles from April 1, 2021 to June 30, 2022. HFS rates, time to HFS, and proportions of HFS-related treatment modifications were determined. Characteristics between patients with and without HFS were compared and multivariable logistic regression was used to identify risk factors for all-grade HFS and grade ≥2.
RESULTS: Among 369 patients, 185 (50.1%) developed HFS, with 14.6% experiencing grade ≥2 and 21.6% (40/185) underwent treatment modifications. Risk factors for all-grade HFS include older age (OR 1.03 95%CI 1.01, 1.06), prior chemotherapy (OR 2.09 95%CI 1.22, 3.58), higher capecitabine dose (OR 2.96 95%CI 1.62, 5.38), prolonged treatment (OR 1.36 95%CI 1.21, 1.51), folic acid intake (OR 3.27 95%CI 1.45, 7.35) and lower neutrophil count (OR 0.77 95%CI 0.66, 0.89). For HFS grade ≥2, older age (OR 1.04 95%CI 1.01, 1.08), female sex (OR 2.10 95%CI 1.05, 4.18), Chinese race (OR 2.10 95%CI 1.06, 4.18), and higher capecitabine dose (OR 2.62 95%CI 1.28, 5.35) are significant risk factors. Use of calcium channel blockers were associated with reduced risks of all-grade HFS (OR 0.27, 95%CI 0.12, 0.60) and grade ≥2 (OR 0.21 95%CI 0.06, 0.78).
CONCLUSIONS: This study provides real-world data on capecitabine-induced HFS in Malaysian patients and identifies risk factors that may offer insights into its understanding and management.
METHODS: We included adult cancer patients receiving capecitabine at Sarawak General Hospital for at least two cycles from April 1, 2021 to June 30, 2022. HFS rates, time to HFS, and proportions of HFS-related treatment modifications were determined. Characteristics between patients with and without HFS were compared and multivariable logistic regression was used to identify risk factors for all-grade HFS and grade ≥2.
RESULTS: Among 369 patients, 185 (50.1%) developed HFS, with 14.6% experiencing grade ≥2 and 21.6% (40/185) underwent treatment modifications. Risk factors for all-grade HFS include older age (OR 1.03 95%CI 1.01, 1.06), prior chemotherapy (OR 2.09 95%CI 1.22, 3.58), higher capecitabine dose (OR 2.96 95%CI 1.62, 5.38), prolonged treatment (OR 1.36 95%CI 1.21, 1.51), folic acid intake (OR 3.27 95%CI 1.45, 7.35) and lower neutrophil count (OR 0.77 95%CI 0.66, 0.89). For HFS grade ≥2, older age (OR 1.04 95%CI 1.01, 1.08), female sex (OR 2.10 95%CI 1.05, 4.18), Chinese race (OR 2.10 95%CI 1.06, 4.18), and higher capecitabine dose (OR 2.62 95%CI 1.28, 5.35) are significant risk factors. Use of calcium channel blockers were associated with reduced risks of all-grade HFS (OR 0.27, 95%CI 0.12, 0.60) and grade ≥2 (OR 0.21 95%CI 0.06, 0.78).
CONCLUSIONS: This study provides real-world data on capecitabine-induced HFS in Malaysian patients and identifies risk factors that may offer insights into its understanding and management.
摘要：
背景：手足综合征（HFS）显著影响接受卡培他滨治疗的癌症患者的生活质量。这项研究评估了卡培他滨相关的HFS患病率，它对化疗治疗的影响，并确定了多种族马来西亚患者的危险因素。
方法：我们纳入了从2021年4月1日至2022年6月30日在沙捞越总医院接受卡培他滨治疗至少两个周期的成年癌症患者。HFS费率,到HFS的时间，并确定HFS相关治疗改变的比例。比较有和没有HFS的患者的特征，并使用多变量逻辑回归分析确定所有级别HFS和≥2级HFS的危险因素。
结果：在369名患者中，185（50.1%）开发了HFS，14.6%的患者≥2级，21.6%(40/185)的患者接受了治疗修改。所有级别HFS的风险因素包括年龄较大（OR1.0395CI1.01，1.06），先前的化疗（OR2.0995CI1.22，3.58），更高的卡培他滨剂量（OR2.9695CI1.62，5.38），延长治疗（OR1.3695CI1.21，1.51），叶酸摄入量（OR3.2795CI1.45，7.35）和较低的中性粒细胞计数（OR0.7795CI0.66，0.89）。对于HFS等级≥2，年龄较大（OR1.0495CI1.01，1.08），女性（OR2.1095CI1.05，4.18），中国比赛（OR2.1095CI1.06，4.18），和更高的卡培他滨剂量（OR2.6295CI1.28，5.35）是显著的危险因素。使用钙通道阻滞剂与所有级别HFS（OR0.27,95CI0.12,0.60）和≥2级（OR0.2195CI0.06,0.78）的风险降低相关。
结论：这项研究提供了马来西亚患者卡培他滨诱导的HFS的真实数据，并确定了可能为其理解和管理提供见解的风险因素。
方法：我们纳入了从2021年4月1日至2022年6月30日在沙捞越总医院接受卡培他滨治疗至少两个周期的成年癌症患者。HFS费率,到HFS的时间，并确定HFS相关治疗改变的比例。比较有和没有HFS的患者的特征，并使用多变量逻辑回归分析确定所有级别HFS和≥2级HFS的危险因素。
结果：在369名患者中，185（50.1%）开发了HFS，14.6%的患者≥2级，21.6%(40/185)的患者接受了治疗修改。所有级别HFS的风险因素包括年龄较大（OR1.0395CI1.01，1.06），先前的化疗（OR2.0995CI1.22，3.58），更高的卡培他滨剂量（OR2.9695CI1.62，5.38），延长治疗（OR1.3695CI1.21，1.51），叶酸摄入量（OR3.2795CI1.45，7.35）和较低的中性粒细胞计数（OR0.7795CI0.66，0.89）。对于HFS等级≥2，年龄较大（OR1.0495CI1.01，1.08），女性（OR2.1095CI1.05，4.18），中国比赛（OR2.1095CI1.06，4.18），和更高的卡培他滨剂量（OR2.6295CI1.28，5.35）是显著的危险因素。使用钙通道阻滞剂与所有级别HFS（OR0.27,95CI0.12,0.60）和≥2级（OR0.2195CI0.06,0.78）的风险降低相关。
结论：这项研究提供了马来西亚患者卡培他滨诱导的HFS的真实数据，并确定了可能为其理解和管理提供见解的风险因素。
