A single-institution experience with concurrent capecitabine and radiation therapy in gastrointestinal malignancies.
OBJECTIVE
We report our clinical experience with 32 patients receiving concurrent irradiation and capecitabine.


METHODS
Medical records of patients with gastrointestinal malignancies treated with radiation and capecitabine therapy were reviewed.


RESULTS
The population consisted of 20 males and 12 females, with a median age of 67.5 years (45-84 years) and adequate hepatic and bone marrow function. Histology was adenocarcinoma in all patients, except two with esophageal squamous carcinoma. Twenty-one patients received the regimen as adjuvant therapy, three received preoperative therapy, and 8 patients received therapy for palliation. The median dose of capecitabine was 1600 mg/m(2)/day (1200-2500 mg/m(2)/day) orally for 5 days per week for the duration of radiation therapy. Thirty patients received a total dose ranging from 45 Gy to 64 Gy over 4-6 weeks. Two previously radiated patients received total doses of 29.9 Gy and 46 Gy. Grade 3/4 toxicities observed were neutropenia in 3 patients and diarrhea, thrombocytopenia, fatigue, and myocardial infarction in 1 patient each. No treatment-related mortality was observed. Twenty of 21 patients (95.2%) who received adjuvant therapy continue to be in complete remission. Four of 11 (36%) evaluable patients demonstrated a response.


CONCLUSIONS
Concurrent capecitabine and radiation were very well tolerated and warrant further investigation in prospective trials.
Vaishampayan
U N
UN
Department of Internal Medicine, Division of Oncology, The Barbara Ann Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, MI, USA. vaishamu@karmanos.org
Ben-Josef
E
E
Philip
P A
PA
Vaitkevicius
V K
VK
Du
W
W
Levin
K J
KJ
Shields
A F
AF
D000230:Adenocarcinoma / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D000368:Aged; D000369:Aged, 80 and over; D000964:Antimetabolites, Antineoplastic / Q000009:adverse effects / Q000627:therapeutic use*; D000069287:Capecitabine; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D003131:Combined Modality Therapy; D003841:Deoxycytidine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D004938:Esophageal Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D005260:Female; D005472:Fluorouracil / Q000031:analogs & derivatives; D005770:Gastrointestinal Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011879:Radiotherapy Dosage; D020266:Radiotherapy, Conformal; D012074:Remission Induction; D012189:Retrospective Studies; D016019:Survival Analysis
D000964:Antimetabolites, Antineoplastic; D003841:Deoxycytidine; D000069287:Capecitabine; D005472:Fluorouracil