Skip to main content

Table 3 Self-report of adverse events 2

From: Study protocol of a single-arm phase 2 study evaluating the preventive effect of topical hydrocortisone for capecitabine-induced hand-foot syndrome in colorectal cancer patients receiving adjuvant chemotherapy with capecitabine plus oxaliplatin (T-CRACC study)

Side effect self-report 2

        

Name

        

Date

        
 

Grade

/

/

/

/

/

/

/

Nausea

        

Tolerable

1

       

If I use anti-nausea drugs, I can manage to eat

2

       

I can hardly eat because of nausea

3

       

Anorexia

        

I have a slight loss of appetite

1

       

I can eat somehow

2

       

I can hardly eat

3

       

Malaise

        

I am a little tired, but it does not interfere with my daily life

1

       

I often lie down

2

       

I lie down more often than I am awake

3

       

Bedridden all day long

4

       

Diarrhea

        

Increased defecation frequency less than 4 times a day compared to usual

1

       

Increased defecation frequency 4–6 times a day compared to usual

2

       

Increased defecation frequency more than 7 times a day compared to usual

3

       

If you have any other symptoms of concern, please write them down