{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T22:43:22Z","timestamp":1777934602397,"version":"3.51.4"},"reference-count":15,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2022,7,29]],"date-time":"2022-07-29T00:00:00Z","timestamp":1659052800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Oncol Pharm Pract"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Capecitabine is a pre-metabolite of 5-fluorouracil and is used as a chemotherapeutic agent. Among the common side effects of capecitabine, there are gastrointestinal side effects including nausea, vomiting, and diarrhea, and dermatological side effects including hand-foot syndrome and skin pigmentation change. However, neurological side effects of capecitabine are very rare. We describe herein a patient who developed neurological side effects in the form of agraphia and dysarthria on the 7th day of capecitabine treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Report<\/jats:title>\n                    <jats:p>A 34-year-old male patient, who was being followed up with the diagnosis of colon cancer, presented with speech and writing disorder that developed while under capecitabine treatment. Dysarthria and agraphia were detected in his neurological examination. Diffusion-weighted magnetic resonance imaging (MRI) revealed acute diffusion restriction in the splenium of the corpus callosum and at the level of the bilateral centrum semiovale. Brain MRI revealed symmetrical T2-weighted fluid-attenuated inversion recovery (T2-FLAIR) signal increases at the right temporoparietal medial, corpus callosum level, and bilateral white matter level.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Management &amp; Outcome<\/jats:title>\n                    <jats:p>The capecitabine treatment was terminated, and methylprednisolone treatment was administered and plasmapheresis procedure was carried out. Subsequently, significant improvement was observed in the clinical findings and neuroimaging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Capecitabine is used as an oral agent; thus, it provides ease of use. Neurological side effects associated with the use of capecitabine reportedly occur very rarely. The findings of this case demonstrated that leukoencephalopathy can be seen during the use of capecitabine, imaging results are very important in the diagnosis of leukoencephalopathy, and improvement can be achieved with the termination of the capecitabine treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10781552221116329","type":"journal-article","created":{"date-parts":[[2022,7,29]],"date-time":"2022-07-29T03:13:46Z","timestamp":1659064426000},"page":"746-749","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Capecitabine-related neurotoxicity presenting with agraphia"],"prefix":"10.1177","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0773-7780","authenticated-orcid":false,"given":"Dilek","family":"Iscan","sequence":"first","affiliation":[{"name":"Ni\u011fde \u00d6mer Halisdemir University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rumeysa","family":"Tolay","sequence":"additional","affiliation":[{"name":"Cukurova University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ertugrul","family":"Bayram","sequence":"additional","affiliation":[{"name":"Cukurova University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Turgay","family":"Demir","sequence":"additional","affiliation":[{"name":"Cukurova University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sebnem","family":"Bicakci","sequence":"additional","affiliation":[{"name":"Cukurova University"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,7,29]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000187313.83515.7e"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/1078155220914704"},{"key":"e_1_3_2_4_2","first-page":"105","article-title":"Kapesitabin tedavisi alan hastada geli\u015fen el-ayak sendromu","volume":"40","author":"Uslu G","year":"2006","unstructured":"Uslu G, Karaman G, Uslu M, et al. Kapesitabin tedavisi alan hastada geli\u015fen el-ayak sendromu. T\u00dcRKDERM-Deri Hastal\u0131klar\u0131 ve Frengi Ar\u015fivi 2006; 40: 105\u2013107.","journal-title":"T\u00dcRKDERM-Deri Hastal\u0131klar\u0131 ve Frengi Ar\u015fivi"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/CAD.0b013e3282f945aa"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/CAD.0000000000000737"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00280-005-0159-4"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.0961-18"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1136\/practneurol-2018-002121"},{"key":"e_1_3_2_10_2","first-page":"251","article-title":"Late-onset leukoencephalopathy induced by long-term chemotherapy with capecitabine and cyclophosphamide for liver metastasis from breast cancer","volume":"52","author":"Yasaki S","year":"2012","unstructured":"Yasaki S, Tukamoto Y, Yuasa N, et al. Late-onset leukoencephalopathy induced by long-term chemotherapy with capecitabine and cyclophosphamide for liver metastasis from breast cancer. Clin Neurol 2012; 52: 251\u2013256.","journal-title":"Clin Neurol"},{"key":"e_1_3_2_11_2","article-title":"Capecitabine induced multifocal leukoencephalopathy: do we have always to switch off the chemotherapy?","volume":"2408269","author":"Bougea A","year":"2016","unstructured":"Bougea A, Voskou P, Kilidireas C, et al. Capecitabine induced multifocal leukoencephalopathy: do we have always to switch off the chemotherapy? Case Rep Oncol Med 2016;2016:2408269.","journal-title":"Case Rep Oncol Med"},{"key":"e_1_3_2_12_2","first-page":"477","article-title":"Severe neurotoxicity following 5-fluorouracil-based chemotherapy in a patient with dihydropyrimidine dehydrogenase deficiency","volume":"2","author":"Takimoto CH","year":"1996","unstructured":"Takimoto CH, Lu ZH, Zhang R, et al. Severe neurotoxicity following 5-fluorouracil-based chemotherapy in a patient with dihydropyrimidine dehydrogenase deficiency. Clin Cancer Res 1996; 2: 477\u2013481. PMID: 9816193.","journal-title":"Clin Cancer Res"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1186\/jbiol69"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.3941\/jrcr.v10i3.2686"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuro.2017.05.001"},{"key":"e_1_3_2_16_2","first-page":"237","article-title":"Kapesitabin kemoterapisine ikincil ensefalopati: bir olgu sunumu ve tart\u0131\u015fma","volume":"15","author":"Tipples K","year":"2009","unstructured":"Tipples K, Kolluri RB, Raouf S. Kapesitabin kemoterapisine ikincil ensefalopati: bir olgu sunumu ve tart\u0131\u015fma. 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