In this first comparison published to date, both PAX and CC offer efficacious protection against hair loss, in particular when docetaxel is administered in a 3-weekly interval.

Objectives: While oral anticancer treatment has increased the convenience for patients with no risk of venous access complications compared to intravenous drug administration, a high level of compliance cannot always be assumed. The aim of the present report was to evaluate real-life drug adherence in a prospective cohort analysis of patients with gastrointestinal or breast cancer treated with capecitabine-based chemotherapy. Methods: Twenty-nine Swiss oncologists recruited patients receiving capecitabine, either as monotherapy or in combination with other chemotherapeutic agents, in a prospective fashion. Patients recorded both their capecitabine intake and any adverse effects each day in patient diaries. Results: A total of 177 patients were included, 143 (81%) with gastrointestinal tumours and 34 (19%) with breast cancer. Overall, 161 patients (91%) were considered as fully compliant, while 16 patients (9%) reported some kind of compliance error. Reasons for non-compliance included forgetting to take treatment (n = 9), side effects (n = 4) and misunderstanding instructions (n = 3). Self-reported compliance was not influenced by age or Eastern Cooperative Oncology Group performance status, but there was a trend towards better compliance with capecitabine therapy if fewer adverse effects occurred (p = 0.07, simple logistic regression). Conclusions: Self-reported compliance with capecitabine-based therapy in clinical practice is high and seems to be adversely affected by side effects.

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Frank cachexia is usually evident in the clinical evaluation, but important metabolic alterations in tumour-bearing patients with slight weight changes are frequently overlooked. Since several factors are involved in cancer-induced malnutrition (marasmus type descriptive of general inadequate food intake, kwashiorkor type descriptive of inadequate protein intake/increased turnover), medical/dietary history and physical examination (dynamic weight loss, vitamin/mineral deficiency) should be complemented by simple additional laboratory tests. Minimal baseline testing may include: weight loss (> 5%/month = severe) and serum albumin (< 24 g/l = severe). Anthropometric measurements (triceps skin fold, midarm muscle circumference) for the assessment of fat deposits and lean body mass are rarely used in a routine clinical setting owing to great variations among individuals and interobserver measurement variability. The Prognostic Nutritional Index (PNI), including serum parameters, immune competence testing and anthropometrics (but no further dietary parameters, i.e. dynamic weight loss), has proved to be quite a reliable method of predicting postoperative morbidity/mortality and of selecting cancer patients for aggressive preoperative nutritional interventions. For clinical studies including the evaluation of nutritional status (stratification, prognostic impact) and/or outcome (nutritional interventions), a simple standardized and validated assessment protocol including dietary history, specific physical examination and widely available laboratory testing should be implemented to document significant nutritional alterations. Body weight alone will often fail to demonstrate important disease- or therapy-related changes in caloric intake or metabolic rate.

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