Advancements in the diagnosis and management of capecitabine-induced hand-foot syndrome.

Abstract

Purpose: This narrative review aims to synthesize existing evidence on hand-foot syndrome (HFS) associated with capecitabine therapy. By examining HFS pathogenesis, clinical manifestations, severity classifications, influencing factors, and management strategies, the study seeks to provide clinically actionable insights to mitigate HFS-related quality-of-life deterioration and treatment discontinuation in patients receiving this widely used capecitabine.

Methods: This narrative review summarizes recent literature on HFS caused by capecitabine, highlighting its relationship among different populations and the prevention and treatment of HFS.

Results: The review establishes that HFS manifests through sensory abnormalities (tingling, numbness) and dermatological changes (erythema, desquamation), though its precise pathophysiology remains incompletely defined. Incidence is modulated by demographic variables (age, sex, ethnicity), therapeutic variables (drug combinations, capecitabine dosage), and possibly genetic factors. The study highlights that co-administration of diclofenac demonstrates significant potential in reducing both HFS occurrence and symptom severity based on current evidence.

Conclusion: Based on critical assessment of available literature, the review concludes that the concomitant use of diclofenac with capecitabine represents an effective clinical strategy for alleviating HFS. In addition, topical urea cream, pyridoxal, lactic acid, etc. can also be used prophylactically to produce certain effects. This pharmacological approach is recommended to enhance treatment adherence and preserve patient quality of life during antineoplastic therapy.