Combining Adjuvant Radiotherapy With Capecitabine in Chemotherapy-resistant Breast Cancer: Feasibility, Safety, and Toxicity.

Autor: Sherry AD; Vanderbilt University School of Medicine, Nashville, TN., Mayer IA; Division of Hematology and Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN., Ayala-Peacock DN; Department of Radiation Oncology, Vanderbilt University Medical Center, Nashville, TN., Abramson VG; Division of Hematology and Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN., Rexer BN; Division of Hematology and Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN., Chakravarthy AB; Department of Radiation Oncology, Vanderbilt University Medical Center, Nashville, TN. Electronic address: bapsi.chak@vumc.org.
Jazyk: angličtina
Zdroj: Clinical breast cancer [Clin Breast Cancer] 2020 Aug; Vol. 20 (4), pp. 344-352.e1. Date of Electronic Publication: 2020 Mar 06.
DOI: 10.1016/j.clbc.2020.02.010
Abstrakt: Background: In a randomized trial (CREATE-X), patients with residual disease after standard neoadjuvant chemotherapy had improved survival with the addition of adjuvant capecitabine. For patients who required radiotherapy (RT), capecitabine was given sequentially. Concurrent capecitabine-RT might be more efficacious. We hypothesized that the safety, feasibility, and toxicity of adjuvant capecitabine-RT would not be significantly different compared with adjuvant RT alone.
Patient and Methods: We retrospectively studied the data from patients with stage I-III invasive mammary carcinoma. Patients who had received capecitabine-RT were matched 1:3 with control patients who had received RT alone. Logistic regression analysis was used to evaluate the predictors of radiation dermatitis.
Results: A total of 64 patients were enrolled, including 16 who had received capecitabine-RT and 48 who had received RT alone. The cohorts were balanced regarding the clinicopathologic factors. No treatment in either cohort resulted in hospitalization, short-term disability, or fatality. Most toxicities of capecitabine-RT were related to radiation dermatitis. Radiation dermatitis was not significantly different between the capecitabine-RT and RT cohort at either grade 2 (odds ratio [OR], 1.36; 95% confidence interval [CI], 0.38-4.93; P = .63) or grade 3 (OR, 3.00; 95% CI, 0.85-10.63; P = .09) or after multivariable analysis. However, the capecitabine-RT group was more likely to require modifications in the RT schedule, including treatment breaks or cancelled fractions (44% vs. 17%; OR, 3.89; 95% CI, 1.12-13.52; P = .03).
Conclusion: Capecitabine-RT appears to be safe in the adjuvant treatment of breast cancer with comparable toxicity to RT alone. It might require more treatment adjustments. Prospective studies are needed to evaluate the safety and tolerability of this combination.
(Copyright © 2020 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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