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Background <p>Hand‒foot syndrome (HFS) is a common cutaneous toxicity of capecitabine that can impair treatment continuity and quality of life. This study aimed to assess the prevalence, clinical characteristics, and factors associated with capecitabine-induced HFS.</p> Methods <p>A cross-sectional analytical study was conducted at Khartoum Oncology Hospital, Sudan (June–October 2022), among adult patients with cancer receiving capecitabine monotherapy. Hand‒foot syndrome was evaluated using the National Cancer Institute Common Terminology Criteria for Adverse Events and a modified Black Patient Scale. Multivariable logistic regression was used to identify factors associated with HFS, with adjusted odds ratios (aORs) and 95% confidence intervals (CIs) reported. Data analysis was performed using SPSS version 27.</p> Results <p>A total of 135 patients were included in the analysis, 90 (66.7%) of whom were female and 52 (38.5%) were aged 56–70 years. The most common cancer type was breast cancer (<i>n</i> = 56) [41.5%]. The overall prevalence of HFS was 74 (54.8%), with 37 (50.0%) involving the hands only and 28 (37.8%) involving both the hands and feet. Onset occurred within 7–21 days in 47 (63.5%) patients. Pain was reported by 41 (30.4%), predominantly moderate by 20 (48.8). Grade I was the most frequent by National Cancer Institute criteria (<i>n</i> = 33) [44.5%] and the Black Patient Scale (<i>n</i> = 33) [44.5%]. Hand‒foot syndrome was more prevalent in female patients (<i>n</i> = 58) [64.4%, <i>p</i> = 0.001], patients with breast cancer (<i>n</i> = 35) [62.5%] (<i>p</i> = 0.049), and those receiving &gt;&#xa0;6 cycles (<i>n</i> = 6) [75%] (<i>p</i> = 0.006). After adjustment, female sex (aOR = 0.224, 95% CI 0.074–0.681; <i>p</i> = 0.008), patients without concomitant diseases (aOR = 2.389, 95% CI 1.011–5.646; <i>p</i> = 0.047), and patients receiving 4–6 cycles compared with those receiving 1–3 cycles (aOR = 0.359, 95% CI 0.155–0.828; <i>p</i> = 0.016) were independent predictors.</p> Conclusions <p>Capecitabine-induced HFS affects more than half of patients and generally occurs early in onset. After adjustment, female patients and those who received 4–6 chemotherapy cycles were less likely to experience HFS, whereas the absence of concomitant diseases was associated with a greater likelihood of developing HFS. Early monitoring and proactive supportive care remain essential to optimize treatment continuity.</p>

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Prevalence, Clinical Characteristics, and Factors Associated with Capecitabine-Induced Hand–Foot Syndrome in Patients with Cancer: Evidence from Sudan

  • 期刊论文

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  • 发表日期：

    2026年4月3日

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  • Ola K. Obeid,
  • Bashir A. Yousef,
  • Yousif B. Hamadalneel,
  • Mawahib A. Mustafa,
  • Amani Abdelaziz Mahmoud,
  • Elkhanssa Abdelhameed Ahmed Elhag

摘要

Background

Hand‒foot syndrome (HFS) is a common cutaneous toxicity of capecitabine that can impair treatment continuity and quality of life. This study aimed to assess the prevalence, clinical characteristics, and factors associated with capecitabine-induced HFS.

Methods

A cross-sectional analytical study was conducted at Khartoum Oncology Hospital, Sudan (June–October 2022), among adult patients with cancer receiving capecitabine monotherapy. Hand‒foot syndrome was evaluated using the National Cancer Institute Common Terminology Criteria for Adverse Events and a modified Black Patient Scale. Multivariable logistic regression was used to identify factors associated with HFS, with adjusted odds ratios (aORs) and 95% confidence intervals (CIs) reported. Data analysis was performed using SPSS version 27.

Results

A total of 135 patients were included in the analysis, 90 (66.7%) of whom were female and 52 (38.5%) were aged 56–70 years. The most common cancer type was breast cancer (n = 56) [41.5%]. The overall prevalence of HFS was 74 (54.8%), with 37 (50.0%) involving the hands only and 28 (37.8%) involving both the hands and feet. Onset occurred within 7–21 days in 47 (63.5%) patients. Pain was reported by 41 (30.4%), predominantly moderate by 20 (48.8). Grade I was the most frequent by National Cancer Institute criteria (n = 33) [44.5%] and the Black Patient Scale (n = 33) [44.5%]. Hand‒foot syndrome was more prevalent in female patients (n = 58) [64.4%, p = 0.001], patients with breast cancer (n = 35) [62.5%] (p = 0.049), and those receiving > 6 cycles (n = 6) [75%] (p = 0.006). After adjustment, female sex (aOR = 0.224, 95% CI 0.074–0.681; p = 0.008), patients without concomitant diseases (aOR = 2.389, 95% CI 1.011–5.646; p = 0.047), and patients receiving 4–6 cycles compared with those receiving 1–3 cycles (aOR = 0.359, 95% CI 0.155–0.828; p = 0.016) were independent predictors.

Conclusions

Capecitabine-induced HFS affects more than half of patients and generally occurs early in onset. After adjustment, female patients and those who received 4–6 chemotherapy cycles were less likely to experience HFS, whereas the absence of concomitant diseases was associated with a greater likelihood of developing HFS. Early monitoring and proactive supportive care remain essential to optimize treatment continuity.