title: Low-dose capecitabine in breast cancer patients with symptomatic bone marrow infiltration: a case study.
abstract: BACKGROUND
  The prognosis of patients with metastatic breast cancer and symptomatic bone marrow involvement is poor. The aim of treatment to these patients is palliation. In this study, we sought to determine the efficacy of therapy with low doses of capecitabine in this subgroup of patients.
  
  
  METHODS
  Five consecutive breast cancer patients with overt bone marrow involvement were treated by low doses of capecitabine in our department. Four out of five patients also received bisphosphonates to palliate skeletal symptoms. The influence of this therapeutic regimen on tumor response, blood count normalization and overall survival was analysed.
  
  
  RESULTS
  All patients except one responded in terms of their haematological profile within two months of the initiation of treatment. Duration of haematological response was 8+ months for all patients. In two of them, tumor response in other sites was evaluated as stable disease, in one as partial remission and in one as progressive disease. Two patients survived more than 22 months without bone marrow failure.
  
  
  CONCLUSIONS
  These initial results are very encouraging for this subset of patients with poor prognosis and limited life expectancy. The administration of capecitabine might be an efficient alternative treatment option. Our results merit further investigation.
authors.affiliation: First Department of Medical Oncology, Aghios Savvas Anticancer Hospital, Athens, Greece. ardavanis@yahoo.com
authors.forename: A
authors.initials: A
authors.lastname: Ardavanis
authors.forename: P
authors.initials: P
authors.lastname: Kountourakis
authors.forename: G
authors.initials: G
authors.lastname: Orphanos
authors.forename: G
authors.initials: G
authors.lastname: Rigatos
mesh_terms: D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage*; D019046:Bone Marrow Neoplasms / Q000188:drug therapy* / Q000556:secondary*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D000069287:Capecitabine; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000031:analogs & derivatives*; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging
chemical_list: D000964:Antimetabolites, Antineoplastic; D003841:Deoxycytidine; D000069287:Capecitabine; D005472:Fluorouracil