Breast Cancer

, Volume 17, Issue 4, pp 298–302

Impact of prophylactic pyridoxine on occurrence of hand–foot syndrome in patients receiving capecitabine for advanced or metastatic breast cancer

  • Nobuyasu Yoshimoto
  • Toshinari Yamashita
  • Takashi Fujita
  • Hironori Hayashi
  • Nobuyuki Tsunoda
  • Mariko Kimura
  • Norimasa Tsuzuki
  • Hiroko Yamashita
  • Tatsuya Toyama
  • Naoto Kondo
  • Hiroji Iwata
Original Article

DOI: 10.1007/s12282-009-0171-3

Cite this article as:
Yoshimoto, N., Yamashita, T., Fujita, T. et al. Breast Cancer (2010) 17: 298. doi:10.1007/s12282-009-0171-3

Abstract

Background

Capecitabine, an oral fluoropyrimidine, has shown consistently high efficacy in anthracycline- and/or taxane-pretreated advanced and metastatic breast cancer. The safety profile of capecitabine is characterized by hand–foot syndrome (HFS), which, although not life threatening, can impair patients’ quality of life if it is not managed promptly and effectively. We conducted a study to assess the impact of prophylactic pyridoxine on HFS.

Methods

Prophylactic pyridoxine was given to 38 patients receiving capecitabine (alone or in combination with cyclophosphamide) for metastatic breast cancer and compared with historical data from 40 patients receiving capecitabine without pyridoxine in our clinic. The impact of urea ointment on HFS was also assessed.

Results

HFS developed in 20 patients (52.6%) receiving pyridoxine compared with historical data showing an 82.5% rate in patients receiving no pyridoxine prophylaxis (p < 0.01). A nonsignificant trend towards less severe HFS was seen among patients who received urea ointment at first appearance of symptoms. In addition, nonsignificant trends towards higher rates of HFS were seen among those who were ≥61 years and those who derived clinical benefit (clinical response or stable disease).

Conclusions

Prophylactic pyridoxine and urea ointment at first appearance of symptoms appears to reduce the risk of severe capecitabine-induced HFS. However, randomized data are required to determine the true effect of these measures.

Keywords

Capecitabine Hand–foot syndrome Pyridoxine prophylaxis Urea ointment 

Copyright information

© The Japanese Breast Cancer Society 2009

Authors and Affiliations

  • Nobuyasu Yoshimoto
    • 1
  • Toshinari Yamashita
    • 1
  • Takashi Fujita
    • 1
  • Hironori Hayashi
    • 1
  • Nobuyuki Tsunoda
    • 1
  • Mariko Kimura
    • 1
  • Norimasa Tsuzuki
    • 1
  • Hiroko Yamashita
    • 2
  • Tatsuya Toyama
    • 2
  • Naoto Kondo
    • 2
  • Hiroji Iwata
    • 1
  1. 1.Department of Breast OncologyAichi Cancer Center HospitalAichiJapan
  2. 2.Department of Breast and Endocrine SurgeryNagoya City UniversityAichiJapan

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