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首页> 外文期刊>Anticancer Research: International Journal of Cancer Research and Treatment >Capecitabine as a Radiosensitizer in Adjuvant Chemoradiotherapy for Pancreatic Cancer: A Retrospective Study
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Capecitabine as a Radiosensitizer in Adjuvant Chemoradiotherapy for Pancreatic Cancer: A Retrospective Study

机译：Capecitabine作为糖类化学疗法胰腺癌的辐射敏化剂：回顾性研究

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Aim: Pancreatic cancer remains one of the deadliest cancer diagnoses and is the fourth leading cause of cancer-related deaths in the U.S. Surgery is the mainstay of treatment for the 20% for whom the tumor is resectable, however, controversy exists over the appropriate adjuvant therapy where local recurrence rates remain strikingly high (50-85%). We aimed to evaluate the safety and efficacy of adding capecitabine (a known radiosensitizer by direct and abscopal effects) to concurrent radiation in the adjuvant setting after resection of pancreatic adenocarcinoma. Patients and Methods: We conducted a retrospective study of 63 patients diagnosed from 2004-2013 with histopathologically-confirmed stage I/II pancreatic cancer treated with a surgical resection followed by adjuvant concurrent chemoradiation to at least 45 Gy using 3D planning and capecitabine at 1,600 mg/m(2)/day (Monday-Friday) for 6 weeks. This was combined with either 4 months of gemcitabine at 1,000 mg/m(2) weekly for 3 out of 4 weeks or capecitabine at 2,000 mg/m(2) for 14 days every 3 weeks for a total of 4 months. Results: The majority of patients were over 65 years old (71%), male (60%), had negative surgical margins (79%), had pancreatic head or neck involvement (71%), Eastern Cooperative Oncology Group performance score of 1 (71%), and a cancer antigen 19-9 in the range of 11-100 U/ml at the time of diagnosis (51%). Of the 63 patients reviewed, 61 patients (97%) completed concurrent chemoradiotherapy. Treatment was halted in one patient due to gastritis and a second for gastrointestinal bleeding. Otherwise, adverse reactions during concurrent chemoradiotherapy were well-tolerated and the majority were Common Terminology Criteria for Adverse Events grades 1 and 2. Grade 3 toxicity was anorexia (n=2) and hand and foot syndrome (n=2) and GI bleeding (n=1). The only grade 4 toxicities were anorexia (n=1) and fatigue (n=1). The median follow-up of patients at the time of analysis was 36 months. The median survival of the entire cohort was 23.5 (range=8.5-42) months. The 1-, 2- and 3-year survival rates were 80%, 35% and 25%, respectively. Conclusion: Concurrent chemoradiation using capecitabine as a radiosensitizer in the adjuvant setting for pancreatic cancer was completed by the vast majority of patients in this series. Treatment was relatively well-tolerated, and its efficacy seems comparable to that for historical controls. This study probably represents the largest yet reported using capecitabine in this setting. Future studies including an increased sample size are required.
机译：目的：胰腺癌仍然是最致命的癌症诊断之一，是美国手术中癌症相关死亡的第四个主要原因是治疗的主要疗法，但肿瘤是可重便的20％，然而，在适当的佐剂上存在争议局部复发率保持惊人的疗法（50-85％）。我们的旨在评估加入Capecitabine（一种已知的辐射敏化剂通过直接且横渐效应）在切除胰腺腺癌后佐剂设置中的同时辐射的安全性和功效。患者和方法：我们对2004 - 2013年诊断的63名患者进行了回顾性研究，所述组织病理学证实的阶段I / II胰腺癌用手术切除治疗，然后使用3D规划和Capecitabine在1,600毫克的3D规划中进行佐剂并发趋化癌。 / m（2）/日（星期一星期五）6周。将其与每周1,000mg / m（2）的吉西他滨的4个月合并为3周或氯萘三滨，每3周为2,000mg / m（2），共14天，共计4个月。结果：大多数患者超过65岁（71％），男性（60％），具有负面手术边距（79％），具有胰腺头或颈部受累（71％），东方合作肿瘤组性能得分为1 （71％）和癌症抗原19-9的诊断时11-100 u / ml（51％）。在审查的63名患者中，61名患者（97％）完成同时进行化学疗法。由于胃炎和胃肠道出血，治疗在一个患者中停止治疗。否则，同时化学疗法期间的不良反应被耐受良好耐受，大多数是不良事件的常见术语标准1和2. 3级毒性是厌食（n = 2）和手和脚综合征（n = 2）和gi出血（ n = 1）。唯一的4级毒性是厌食（n = 1）和疲劳（n = 1）。分析时的患者中位后续36个月。整个队列的中位存活率为23.5（范围= 8.5-42）个月。 1-，2-和3年生存率分别为80％，35％和25％。结论：本系列绝大多数患者完成了使用Capecitabine作为胰腺癌辅助敏化剂的助敏化合物的同步容化。治疗相对良好，其疗效似乎与历史对照相当。本研究可能代表在此设置中使用Capecitabine的最大尚未报告。未来的研究包括增加的样品大小。

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