Comparison of intravenous 5-Fluorouracil with Oral Capecitabine in the Treatment of Anal Squamous Cell Carcinoma Using Modern Radiation Techniques.

Autor:	Schlosser S; Department of Radiation Oncology, Assuta Medical Center, Tel Aviv, Israel., Zalmanov S; Department of Radiation Oncology, Assuta Medical Center, Tel Aviv, Israel, Faculty of Health Science, Soroka University Medical Center, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel., Pfeffer RM; Department of Radiation Oncology, Assuta Medical Center, Tel Aviv, Israel, Faculty of Health Science, Soroka University Medical Center, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel., Lipski Y; Department of Radiation Oncology, Assuta Medical Center, Tel Aviv, Israel, Faculty of Health Science, Soroka University Medical Center, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel., Grinberg V; Department of Radiation Oncology, Assuta Medical Center, Tel Aviv, Israel, Faculty of Health Science, Soroka University Medical Center, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel., Kalmus Y; Department of Radiation Oncology, Assuta Medical Center, Tel Aviv, Israel., Levin D; Department of Radiation Oncology, Assuta Medical Center, Tel Aviv, Israel., Hod K; Department of Academy and Research, Assuta Medical Center, Tel Aviv, Israel., Ben David MA; Department of Radiation Oncology, Assuta Medical Center, Tel Aviv, Israel, Faculty of Health Science, Soroka University Medical Center, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel.
Jazyk:	angličtina
Zdroj:	The Israel Medical Association journal : IMAJ [Isr Med Assoc J] 2023 Feb; Vol. 25 (2), pp. 126-130.
Abstrakt:	Background: Anal squamous cell carcinoma (ASqCC) is a rare malignancy, traditionally treated with combined chemoradiation, with a continuous infusion of 5-fluorouracil (5-FU) and mitomycin C (MMC). Replacing intravenous (IV) 5-FU with oral capecitabine (oral fluoropyrimidine) has been reported as a non-inferior treatment option. However, these data are scarce, with variable results. Objectives: To examine the outcome of patients with ASqCC treated with either IV 5-FU or capecitabine concomitantly with radiation therapy. To compare treatment side effects, local recurrence, and general outcome. Methods: We reviewed charts of patients who were diagnosed with stage I-III ASqCC. All participating patients received chemoradiation at the Assuta Medical Center between 2011 and 2019. Results: In this study, 43 patients with ASqCC were eligible; 14 received 5-FU and 29 were treated with capecitabine. Basic characteristics were similar between the two groups, with longer follow-up for the 5-FU group. Six months following treatment, 100% (13/13 with adequate follow-up) of the 5-FU group had complete clinical response, compared to 84% in the capecitabine group (21/24), P = 0.143. The local recurrence incidence was higher in the 5-FU group at 23% (7, 10, 26 months following therapy, and none in the capecitabine group (P = 0.088). Although local and hematological toxicities were similar between groups, one patient receiving capecitabine died during chemoradiotherapy. Conclusions: Oral capecitabine demonstrated non-inferior disease control in ASqCC treated with chemoradiotherapy. We recommend oral capecitabine over continuous IV 5-FU in locally and locally advanced ASqCC. Close monitoring of side effects is required to reduce major toxicity.
Databáze:	MEDLINE
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