title: A single institution experience with concurrent capecitabine and radiation therapy in weak and/or elderly patients with urothelial cancer.
abstract: OBJECTIVE
  To describe a single institution experience in delivering concurrent capecitabine and radiation in elderly patients with urothelial cancer.
  
  
  METHODS
  The records of patients with urothelial carcinoma treated with capecitabine and radiation at Wayne State University were reviewed. Capecitabine was administered at a median dose of 1600 mg/m2/day (range, 1200-1800 mg/m2). Concurrent radiation therapy (RT) of 40-45 Gy was delivered to a small pelvic field with a four-field technique, with additional boost to tumor area (total, 54-68.4 Gy).
  
  
  RESULTS
  Fourteen patients who were not candidates for cystectomy or cisplatin-based therapy were treated with capecitabine and concurrent radiation therapy. Median age was 80 years (range, 46-88 years). Five patients had a performance status of 3. Nine patients had localized disease, and 5 patients had advanced disease. The most common overall toxicities were fatigue (43%), diarrhea (Grade 2, 14% and Grade 3, 29%), and dehydration (43%), with no Grade 4 or 5 toxicities. Of 14 patients, 3 (20%) required hospitalization for management of toxicities. Seven patients required dose modification, and the therapy was relatively well tolerated. Clinical complete response was seen in 11 of 13 evaluable patients (77%). At a median follow-up of 10.5 months, only 3 of 11 responders had relapsed.
  
  
  CONCLUSIONS
  Concurrent capecitabine and radiation therapy is well-tolerated and demonstrates promising efficacy in urothelial carcinoma, thus offering a tolerable therapeutic option in elderly patients or those with impaired performance status.
authors: Division of Hematology/Oncology, Department of Internal Medicine, Wayne State University, Detroit, MI 48201, USA.
authors: Bhaumik
authors: B
authors: Patel
authors: Jeffrey
authors: J
authors: Forman
authors: Joseph
authors: J
authors: Fontana
authors: Arthur
authors: A
authors: Frazier
authors: Edson
authors: E
authors: Pontes
authors: Ulka
authors: U
authors: Vaishampayan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D000069287:Capecitabine; D002278:Carcinoma in Situ / Q000628:therapy*; D002295:Carcinoma, Transitional Cell / Q000628:therapy*; D003131:Combined Modality Therapy; D003841:Deoxycytidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D005472:Fluorouracil / Q000031:analogs & derivatives; D006801:Humans; D008297:Male; D008875:Middle Aged; D011355:Prodrugs / Q000627:therapeutic use; D011879:Radiotherapy Dosage; D001749:Urinary Bladder Neoplasms / Q000628:therapy*
chemical_list: D000964:Antimetabolites, Antineoplastic; D011355:Prodrugs; D003841:Deoxycytidine; D000069287:Capecitabine; D005472:Fluorouracil