title: Concurrent capecitabine and whole-brain radiotherapy for treatment of brain metastases in breast cancer patients.
abstract: Preclinical data have demonstrated that ionizing radiation acts synergistically with capecitabine. This report retrospectively assessed the use of capecitabine concurrently with whole-brain radiotherapy (WBRT) in patients with brain metastases from breast cancer. From January 2003 to March 2005, five breast cancer patients with brain metastases were referred for WBRT with concurrent capecitabine. Median age was 44 years (range: 38-53). The median dose of capecitabine was 1,000 mg/m(2) twice daily for 14 days (day1-14). Treatment cycles were repeated every 21 days, concurrently with WBRT (30 Gy, 3 Gy per fraction, 5 days per week). Median survival after starting WBRT plus capecitabine was 6.5 months (range 1-34 months). One patient achieved a complete response. Two patients achieved partial response, including one with local control lasting until most recent follow-up. One patient had stable disease. The remaining patient was not assessable for response because of early death. Most commonly reported adverse events were nausea (n = 2) and headache (n = 2), always grade 1. Other toxicities were grade 3 hand/foot syndrome (n = 1), moderate anemia requiring transfusion and dose reduction of capecitabine (n = 1), and grade 1 mucositis (n = 1). Although promising, these preliminary data warrant further assessment of capecitabine-based chemoradiation in brain metastases from breast cancer and need to be further validated in the setting of a clinical trial.
authors.affiliation: Department of Radiation Oncology, Institut Curie, Paris, France.
authors.forename: Cyrus
authors.initials: C
authors.lastname: Chargari
authors.forename: Youlia M
authors.initials: YM
authors.lastname: Kirova
authors.forename: Véronique
authors.initials: V
authors.lastname: Diéras
authors.forename: Pablo
authors.initials: P
authors.lastname: Castro Pena
authors.forename: Pablo Castro
authors.initials: PC
authors.lastname: Pena
authors.forename: Francois
authors.initials: F
authors.lastname: Campana
authors.forename: Paul H
authors.initials: PH
authors.lastname: Cottu
authors.forename: JeanYves
authors.initials: J
authors.lastname: Pierga
authors.forename: Alain
authors.initials: A
authors.lastname: Fourquet
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage; D001932:Brain Neoplasms / Q000556:secondary* / Q000628:therapy*; D001943:Breast Neoplasms / Q000378:metabolism / Q000473:pathology*; D000069287:Capecitabine; D018270:Carcinoma, Ductal, Breast / Q000556:secondary* / Q000628:therapy; D018275:Carcinoma, Lobular / Q000556:secondary* / Q000628:therapy; D003131:Combined Modality Therapy; D016371:Cranial Irradiation; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000031:analogs & derivatives; D006801:Humans; D007150:Immunohistochemistry; D017404:In Situ Hybridization, Fluorescence; D008875:Middle Aged; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D012189:Retrospective Studies
chemical_list: D000970:Antineoplastic Agents; D000069287:Capecitabine; D003841:Deoxycytidine; D005472:Fluorouracil; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone