Authors:
U.N. Vaishampayan, M.D.,*
E. Ben-Josef, M.D.,†
P.A. Philip, M.D.,*
V.K. Vaitkevicius, M.D., F.A.C.P.,*
W. Du, Ph.D.,‡
K.J. Levin, M.D.,† and
A.F. Shields, M.D.*

Abstract:

PURPOSE:
We report our clinical experience with 32 patients receiving concurrent irradiation and capecitabine.

METHODS:
Medical records of patients with gastrointestinal malignancies treated with radiation and capecitabine therapy were reviewed.

RESULTS:
The population consisted of 20 males and 12 females with a median age of 67.5 years (45-84 years), and adequate hepatic and bone marrow function. Histology was adenocarcinoma in all patients except two with esophageal squamous carcinoma. Twenty-one patients received the regimen as adjuvant therapy, three received preoperative therapy and eight patients received therapy for palliation. The median dose of capecitabine was 1600mg/m2/day (1200-2500mg/m2/day) orally for five days per week for the duration of radiation therapy. Thirty patients received a total dose ranging from 45 Gy-64 Gy over 4-6 weeks. Two previously radiated patients received total doses of 29.9 Gy and 46 Gy. Grade 3/4 toxicities observed were neutropenia in three patients, and diarrhea, thrombocytopenia, fatigue and myocardial infarction in one patient each. No treatment related mortality was observed. Twenty of 21 patients (95.2%) receiving adjuvant therapy continue to be in complete remission. Four of eleven (36%) evaluable patients demonstrated a response.

CONCLUSION:
Concurrent capecitabine and radiation was very well tolerated and warrants further investigation in prospective trials.