title: Concurrent capecitabine and upper abdominal radiation therapy is well tolerated.
abstract: We retrospectively evaluated acute toxicity in 88 patients that were treated with capecitabine and concurrent radiotherapy to the upper abdomen. These patients included 28 (32%) with pancreatic adenocarcinoma, 18 (20%) with cholangiocarcinoma, 11 (13%) with ampullary carcinoma, 11 (13%) with other primary tumors, 14 (16%) with liver metastases, and 6 (7%) with metastases at other sites. The median dose of radiotherapy was 45 Gy (range 30-72 Gy). The median dose of capecitabine was 850 mg/m(2) twice daily, with 77% receiving 800-900 mg/m(2) twice daily. The highest grade of acute toxicity was Common Terminology Criteria (CTC) grade 0 in 5 (6%), grade 1 in 60 (68%), grade 2 in 18 (20%), and grade 3 in 5 (6%) patients. No patient had CTC grade 4 toxicity. The most common grade 2 toxicities were nausea, hand-foot syndrome, fatigue, anorexia and diarrhea. The grade 3 toxicities included nausea, vomiting and fatigue. Three patients (3%) required hospitalization due to grade 3 acute toxicity. Capecitabine was interrupted, discontinued or given at an adjusted dose in 13 (15%) patients because of acute toxicity. Therefore, capecitabine and concurrent radiotherapy to the upper abdomen appears to be well tolerated. Capecitabine may serve as an alternative to bolus or infusional 5-FU during chemoradiation for upper gastrointestinal malignancies.
authors.affiliation: Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, USA. prajdas@mdanderson.org
authors.forename: Prajnan
authors.initials: P
authors.lastname: Das
authors.forename: Robert A
authors.initials: RA
authors.lastname: Wolff
authors.forename: James L
authors.initials: JL
authors.lastname: Abbruzzese
authors.forename: Gauri R
authors.initials: GR
authors.lastname: Varadhachary
authors.forename: Douglas B
authors.initials: DB
authors.lastname: Evans
authors.forename: Jean Nicolas
authors.initials: JN
authors.lastname: Vauthey
authors.forename: Andrew
authors.initials: A
authors.lastname: Baschnagel
authors.forename: Marc E
authors.initials: ME
authors.lastname: Delclos
authors.forename: Sunil
authors.initials: S
authors.lastname: Krishnan
authors.forename: Nora A
authors.initials: NA
authors.lastname: Janjan
authors.forename: Christopher H
authors.initials: CH
authors.lastname: Crane
mesh_terms: D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage; D000069287:Capecitabine; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D004307:Dose-Response Relationship, Radiation; D004334:Drug Administration Schedule; D005472:Fluorouracil / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000494:pharmacology; D005770:Gastrointestinal Neoplasms / Q000188:drug therapy / Q000532:radiotherapy; D006801:Humans; D009362:Neoplasm Metastasis; D011878:Radiotherapy / Q000379:methods*; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000964:Antimetabolites, Antineoplastic; D003841:Deoxycytidine; D000069287:Capecitabine; D005472:Fluorouracil