Replacing 5-fluorouracil by capecitabine in localised squamous cell carcinoma of the anal canal: systematic review and meta-analysis
| Autor: | Rachel P. Riechelmann, Raphael L. C. Araujo, Allan Al Pereira, Karla Teixeira Souza, Paulo M. Hoff, Suilane Coelho Ribeiro Oliveira |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Oncology
Cancer Research medicine.medical_specialty anal cancer anal canal neoplasm Gastroenterology Capecitabine 03 medical and health sciences 0302 clinical medicine anus neoplasm Internal medicine medicine Clinical endpoint Anal cancer chemoradiation business.industry Research capecitabine Standard treatment Anal canal medicine.disease medicine.anatomical_structure Fluorouracil 030220 oncology & carcinogenesis Meta-analysis 030211 gastroenterology & hepatology business Chemoradiotherapy medicine.drug |
| Zdroj: | ecancermedicalscience |
| ISSN: | 1754-6605 |
| DOI: | 10.3332/ecancer.2016.699 |
| Popis: | Background The standard treatment for localised squamous cell carcinoma of the anal canal (SCCAC) is chemoradiotherapy (CRT) with infusional 5-fluorouracil (5-FU) and mitomycin. Because 5-FU and capecitabine have offered similar efficacy in many phase-III trials of solid tumours, studies have tested capecitabine in this setting of SCCAC. However, these studies are small and have reported variable results. Therefore, a systematic review and meta-analysis was performed. Methods Medline, Scopus and Embase were searched for studies that evaluated the efficacy outcomes of capecitabine used as a substitute of 5-FU in the CRT of localised SCCAC. The primary endpoint was complete response rate (CRR) at 6 months. Metaprop analysis of reported CRR-based on pooled estimates of proportions with corresponding 95% confidence intervals (95%CI) were calculated on the base of the Freeman-Tukey double arcsine transformation. Results We retrieved 300 studies, of which six met our eligibility criteria. The capecitabine dose ranged from 500 mg/m2 to 825 mg/m2 BID for 5 days per week during radiation. With a total of 218 patients, the median follow-up was 21.5 months (14–23). The pooled analysis of three trials (N = 132 patients) reported a CRR at 6 months of 88% (83%–94%), considering all clinical stages. The pooled analysis of overall CRR (N = 218 patients), evaluated at different intervals, showed an overall CRR of 91% (87%–95%). Rates of locoregional relapse varied from 3.2% to 21%. The majority of patients completed the planned radiotherapy dose (93.5%–100%) and any chemotherapy interruption was reported in up to 55.8% of patients. Conclusions Capecitabine is an acceptable and more convenient alternative to infusional 5-FU in the CRT for localised SCCAC, offering similar clinical CRR to those reported by phase-III trials. |
| Databáze: | OpenAIRE |
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