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Maintenance therapy with capecitabine in patients with locally advanced unresectable pancreatic adenocarcinoma

Therapeutic options for locally advanced pancreatic cancer (LAPC) include concurrent chemoradiation, induction chemotherapy followed by chemoradiation or systemic therapy alone. The original Gastro-Intestinal Study Group and Eastern Cooperative Oncology Group studies defined fluorouracil (5-FU) with...

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Autores principales: SAIF, MUHAMMAD WASIF, LEDBETTER, LESLIE, KALEY, KRISTIN, GARCON, MARIE CARMEL, RODRIGUEZ, TERESA, SYRIGOS, KOSTAS N.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: D.A. Spandidos 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4114599/
https://www.ncbi.nlm.nih.gov/pubmed/25120712
http://dx.doi.org/10.3892/ol.2014.2238
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author SAIF, MUHAMMAD WASIF
LEDBETTER, LESLIE
KALEY, KRISTIN
GARCON, MARIE CARMEL
RODRIGUEZ, TERESA
SYRIGOS, KOSTAS N.
author_facet SAIF, MUHAMMAD WASIF
LEDBETTER, LESLIE
KALEY, KRISTIN
GARCON, MARIE CARMEL
RODRIGUEZ, TERESA
SYRIGOS, KOSTAS N.
author_sort SAIF, MUHAMMAD WASIF
collection PubMed
description Therapeutic options for locally advanced pancreatic cancer (LAPC) include concurrent chemoradiation, induction chemotherapy followed by chemoradiation or systemic therapy alone. The original Gastro-Intestinal Study Group and Eastern Cooperative Oncology Group studies defined fluorouracil (5-FU) with concurrent radiation therapy followed by maintenance 5-FU until progression, as the standard therapy for this subset of patients. Although this combined therapy has been demonstrated to increase local control and median survival from 8 to 12 months, almost all patients succumb to the disease secondary to either local or distant recurrence. Our earlier studies provided a strong rationale for the use of capecitabine in combination with concurrent radiation followed by maintenance capecitabine therapy. To report our clinical experience, we retrospectively evaluated our patients who were treated with maintenance capecitabine. We reviewed the medical records of patients with LAPC who received treatment with capecitabine and radiation, followed by a 4-week rest, then capecitabine alone 1,000 mg twice daily (ECOG performance status 2 or age >70 years) or 1,500 mg twice daily for 14 days every 3 weeks until progressive disease. We treated 43 patients between September 2004 and September 2012. The population consisted of 16 females and 25 males, with a median age of 64 years (range, 38–80 years). Patients received maintenance capecitabine for median duration of 9 months (range, 3–18 months). The median overall survival (OS) for these patients was 17 months, with two patients still living and receiving therapy. The 6-month survival rate was 91% (39/43), 1-year survival rate was 72% (31/43) and 2-year OS rate was 26% (11/43). Grade 3 or 4 toxicity was observed rarely: Hand-foot syndrome (HFS) in two patients, diarrhea in one patient and peripheral neuropathy in one patient, and there was no mortality directly related to treatment. Capecitabine maintenance therapy following chemoradiation in LAPC offers an effective, tolerable and convenient alternative to 5-FU. To the best of our knowledge, this is the largest study of its kind which has determined the safety and efficacy of capecitabine maintenance therapy for patients with LAPC.
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spelling pubmed-41145992014-08-12 Maintenance therapy with capecitabine in patients with locally advanced unresectable pancreatic adenocarcinoma SAIF, MUHAMMAD WASIF LEDBETTER, LESLIE KALEY, KRISTIN GARCON, MARIE CARMEL RODRIGUEZ, TERESA SYRIGOS, KOSTAS N. Oncol Lett Articles Therapeutic options for locally advanced pancreatic cancer (LAPC) include concurrent chemoradiation, induction chemotherapy followed by chemoradiation or systemic therapy alone. The original Gastro-Intestinal Study Group and Eastern Cooperative Oncology Group studies defined fluorouracil (5-FU) with concurrent radiation therapy followed by maintenance 5-FU until progression, as the standard therapy for this subset of patients. Although this combined therapy has been demonstrated to increase local control and median survival from 8 to 12 months, almost all patients succumb to the disease secondary to either local or distant recurrence. Our earlier studies provided a strong rationale for the use of capecitabine in combination with concurrent radiation followed by maintenance capecitabine therapy. To report our clinical experience, we retrospectively evaluated our patients who were treated with maintenance capecitabine. We reviewed the medical records of patients with LAPC who received treatment with capecitabine and radiation, followed by a 4-week rest, then capecitabine alone 1,000 mg twice daily (ECOG performance status 2 or age >70 years) or 1,500 mg twice daily for 14 days every 3 weeks until progressive disease. We treated 43 patients between September 2004 and September 2012. The population consisted of 16 females and 25 males, with a median age of 64 years (range, 38–80 years). Patients received maintenance capecitabine for median duration of 9 months (range, 3–18 months). The median overall survival (OS) for these patients was 17 months, with two patients still living and receiving therapy. The 6-month survival rate was 91% (39/43), 1-year survival rate was 72% (31/43) and 2-year OS rate was 26% (11/43). Grade 3 or 4 toxicity was observed rarely: Hand-foot syndrome (HFS) in two patients, diarrhea in one patient and peripheral neuropathy in one patient, and there was no mortality directly related to treatment. Capecitabine maintenance therapy following chemoradiation in LAPC offers an effective, tolerable and convenient alternative to 5-FU. To the best of our knowledge, this is the largest study of its kind which has determined the safety and efficacy of capecitabine maintenance therapy for patients with LAPC. D.A. Spandidos 2014-09 2014-06-11 /pmc/articles/PMC4114599/ /pubmed/25120712 http://dx.doi.org/10.3892/ol.2014.2238 Text en Copyright © 2014, Spandidos Publications http://creativecommons.org/licenses/by/3.0 This is an open-access article licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License. The article may be redistributed, reproduced, and reused for non-commercial purposes, provided the original source is properly cited.
spellingShingle Articles
SAIF, MUHAMMAD WASIF
LEDBETTER, LESLIE
KALEY, KRISTIN
GARCON, MARIE CARMEL
RODRIGUEZ, TERESA
SYRIGOS, KOSTAS N.
Maintenance therapy with capecitabine in patients with locally advanced unresectable pancreatic adenocarcinoma
title Maintenance therapy with capecitabine in patients with locally advanced unresectable pancreatic adenocarcinoma
title_full Maintenance therapy with capecitabine in patients with locally advanced unresectable pancreatic adenocarcinoma
title_fullStr Maintenance therapy with capecitabine in patients with locally advanced unresectable pancreatic adenocarcinoma
title_full_unstemmed Maintenance therapy with capecitabine in patients with locally advanced unresectable pancreatic adenocarcinoma
title_short Maintenance therapy with capecitabine in patients with locally advanced unresectable pancreatic adenocarcinoma
title_sort maintenance therapy with capecitabine in patients with locally advanced unresectable pancreatic adenocarcinoma
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4114599/
https://www.ncbi.nlm.nih.gov/pubmed/25120712
http://dx.doi.org/10.3892/ol.2014.2238
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