The prevalence of hand-foot syndrome after chemotherapy is high among patients with colorectal cancer (CRC), according to researchers. 

They conducted a meta-analysis of 20 studies and found that nearly half of CRC patients developed hand-foot syndrome after chemotherapy. This finding was published in the International Journal of Colorectal Disease.

The 20 studies encompassed a total of 4773 CRC patients. The studies were published during 1997-2021 and were conducted in 6 countries (China, Italy, Japan, Korea, Spain, and the United States).

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The prevalence of hand-foot syndrome was 49.1% in these studies. Most cases of hand-foot syndrome were grade 1-2 (40.1%), although the rate of grade 3-4 hand-foot syndrome was 5.8%.

The rate of hand-foot syndrome was highest among patients treated with capecitabine alone (68.3%), followed by capecitabine plus oxaliplatin (55.8%), and S-1 plus oxaliplatin (3.8%). 

The studies conducted in China had the highest rate of hand-foot syndrome (55.1%), followed by studies in Japan (50.2%), Korea (32.0%), and Italy (15.9%).

Non-randomized prospective studies had the highest rate of hand-foot syndrome (67.9%), followed by retrospective studies (46.5%) and randomized controlled trials (27.0%). 

The rate of hand-foot syndrome was 50.3% for studies published during 1997-2018 and 44.0% for studies published during 2019-2021.

A meta-regression analysis suggested that the chemotherapy used, type of study, country, and year of study publication were not sources of heterogeneity (P >.05).

“The currently available evidence showed that the prevalence of HFS [hand-foot syndrome] in patients with CRC undergoing chemotherapy is high,” the researchers concluded. “[T]he mechanism of HFS and its relationship with the efficacy of chemotherapy warrant further investigation.”


Huang J, Ye S, Feng S, Zheng M, Zhong M. Prevalence of hand-foot syndrome following chemotherapy for colorectal cancer: A systematic review and meta-analysis. Int J Colorectal Dis. Published online March 6, 2023. doi:10.1007/s00384-023-04345-5