Prophylactic Medium-Class Topical Steroids are Associated with a Lower Incidence of Capecitabine-Induced Hand-Foot...

There is limited clinical research evaluating the role of topical corticosteroids in preventing hand-foot syndrome (HFS) caused by capecitabine. Although the precise cause of HFS remains unclear, inflammatory mechanisms are thought to contribute to its development. This study investigated whether prophylactic use of a medium-class topical corticosteroid was associated with a lower incidence of capecitabine-related HFS in patients with colorectal cancer.

We retrospectively assessed 78 patients prescribed medium-class topical steroids as a preventive against HFS associated with capecitabine and 32 topical steroid-free patients undergoing capecitabine-based chemotherapy. We evaluated the incidence of each grade of HFS during chemotherapy.

Between January 2022 and March 2025, 110 patients were enrolled in the study. Grade ≥ 2 HFS occurred in 23.1% of patients in the medium-class topical steroid group and 50.0% of patients in the topical steroid-free group (OR, 0.30; 95% CI 0.13-0.72; P = 0.012, Fisher's exact test). The incidence of other capecitabine-related adverse events did not differ significantly between the groups.

Our findings suggest that prophylactic use of medium-class topical steroids was associated with a lower incidence of capecitabine-induced hand-foot syndrome. Prospective randomized studies are warranted to confirm these findings.