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HFS Prevention Urea — SCE Medical Oncology MCQ

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EasySupportive & Palliative OncologyHFS Prevention UreaSCE Medical Oncology

A 60-year-old woman on capecitabine for colorectal cancer develops grade 2 palmar-plantar erythrodysaesthesia (painful erythema of palms/soles limiting function). She asks whether topical urea cream helps. What preventive measures reduce capecitabine hand-foot syndrome?

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Correct answer: A — Prophylactic use of 10% urea-based cream, avoiding excessive heat/friction to hands/feet, wearing cotton gloves/socks and comfortable shoes — the SWOG S1012 trial showed urea cream significantly reduces grade 2+ HFS

Prophylactic measures for capecitabine hand-foot syndrome (PPE) include: topical 10% urea cream applied to hands/feet twice daily starting with capecitabine (SWOG S1012 showed significant reduction in grade 2+ PPE), avoiding hot water, friction and pressure on hands/feet, wearing cotton gloves/socks and well-fitting shoes. Pyridoxine (vitamin B6) was NOT shown to be effective in the phase III RCT. Ice gloves/socks during capecitabine are not standard (they are used during taxane infusion for nail protection).

Reference: ESMO 2024 Supportive Care; SWOG S1012 Ren et al JCO 2015; BNF Capecitabine