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Chemoradiotherapy with capecitabine for locally advanced anal carcinoma: an alternative treatment option
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Chemoradiotherapy with capecitabine for locally advanced anal carcinoma: an alternative treatment option
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Journal Article
Chemoradiotherapy with capecitabine for locally advanced anal carcinoma: an alternative treatment option
2014
Overview
Background:
Capecitabine is an established treatment alternative to intravenous 5-fluorouracil (5-FU) for patients with rectal cancer receiving chemoradiotherapy. Its place in the treatment of locally advanced anal carcinoma (AC), however, remains undetermined. We investigated whether capecitabine is as effective as 5-FU in the treatment of patients with locally advanced AC.
Methods:
One hundred and five patients with squamous cell AC stage T2-4 (T2>4 cm), N0-1, M0 or T1-4, N2-3, M0, were included in this retrospective study. Forty-seven patients were treated with continuous 5-FU (750 mg m
−2
) on days 1–5 and 29–33, mitomycin C (MMC, 10 mg m
−2
) on day 1, and radiotherapy; 58 patients were treated with capecitabine (825 mg m
−2
b.i.d. on weekdays), MMC (10 mg m
−2
) on day 1, and radiotherapy. The primary end points of the study were: clinical complete response rate, locoregional control (LRC) and overall survival (OS). Secondary end points were: colostomy-free survival (CFS), toxicity and associations of genetic polymorphisms (
GSTT1
,
GSTM1
,
GSTP1
and
TYMS
) with outcome and toxicity.
Results:
Clinical complete response was achieved in 41/46 patients (89.1%) with 5-FU and in 52/58 patients (89.7%) with capecitabine. Three-year LRC was 76% and 79% (
P
=0.690, log-rank test), 3-year OS was 78% and 86% (
P
=0.364, log-rank test) and CFS was 65% and 79% (
P
=0.115, log-rank test) for 5-FU and capecitabine, respectively.
GSTT1
and
TYMS
genotypes were associated with severe (grade 3–4) toxicity.
Conclusions:
Capecitabine combined with MMC and radiotherapy was equally effective as 5-FU-based chemoradiotherapy. This study shows that capecitabine can be used as an acceptable alternative to 5-FU for the treatment of AC.
Publisher
Nature Publishing Group UK,Nature Publishing Group
Subject
/ Adult
/ Aged
/ Antineoplastic Combined Chemotherapy Protocols - therapeutic use
/ Biological and medical sciences
/ Biomedical and Life Sciences
/ Carcinoma, Squamous Cell - mortality
/ Carcinoma, Squamous Cell - pathology
/ Carcinoma, Squamous Cell - therapy
/ Deoxycytidine - administration & dosage
/ Deoxycytidine - analogs & derivatives
/ Female
/ Fluorouracil - administration & dosage
/ Fluorouracil - analogs & derivatives
/ Gastroenterology. Liver. Pancreas. Abdomen
/ Humans
/ Male
/ Mitomycin - administration & dosage
/ Multiple tumors. Solid tumors. Tumors in childhood (general aspects)
/ Oncology
/ Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
/ Toxicity
/ Tumors
