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Capecitabine “metronomic” chemotherapy for palliative treatment of elderly patients with advanced gastric cancer after fluoropyrimidine-based chemotherapy

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Abstract

We aimed to study the efficacy and safety of metronomic capecitabine in pretreated elderly patients with advanced gastric cancer. Eligible patients with advanced gastric cancer were treated with capecitabine at a fixed dose 1,000 mg daily (days 1–28 continuously, every 5 weeks) until disease progression or significant toxicity. Tumor response was assessed every 10 weeks by computed tomography scan using Response Evaluation Criteria in solid tumors. In total, 45 patients were enrolled, of whom 43 were evaluated for efficacy and 45 for safety. A median of 3 cycles (range 1–12) were administered. Metronomic chemotherapy had a disease control rate (DCR) at 8 weeks of 51.1% (95% CI 25.7–67.8), and the objective response rate was 20.9% (95% CI 13.1–38.5, 9 of 43 assessable patients). The median time-to-progression and median overall survival were 3.6 months (95% CI: 3.2–4.0 months) and 7.6 months (95% CI 7.0–8.2 months), respectively. Grade II neutropenia and thrombocytopenia were observed in 13.3 and 2.2% of patients, respectively. Grade II/III nonhematological toxicities included diarrhea (4.4%), stomatitis (13.4%), and hand–foot syndrome (15.5%). No grade IV toxicity, neutropenic fever or treatment-related deaths occurred. Metronomic capecitabine was effective and well tolerated as palliative treatment in elderly patients with advanced gastric cancer after fluoropyrimidine-based chemotherapy.

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Acknowledgments

This project was supported by the Shanghai Nature Science Fund, Shanghai, China (0552nm007).

Conflict of interest

The authors declared no conflicts of interest with respect to authorship and/or publication of this article.

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Authors and Affiliations

  1. Department of Medical Oncology, Cancer Hospital, Minhang Branch, Fudan University, 106 Ruili Road, Minhang District, Shanghai, 200240, China

    ShengLi He & Jie Shen

  2. Department of General Surgery, Shanghai No. 5 People’s Hospital, Fudan University, 801 Heqing Road, Shanghai, 200240, China

    Liang Hong

  3. Department of Integrated Chinese and Western Medicine, Cancer Hospital, Fudan University, 270 Dongan Road, Shanghai, 200032, China

    LuMing Niu

  4. Department of Cancer Center, The First Affiliated Hospital of Bengbu Medical College, 287 Changhuai Road, Bengbu, 233000, China

    DaoYong Niu

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He, S., Shen, J., Hong, L. et al. Capecitabine “metronomic” chemotherapy for palliative treatment of elderly patients with advanced gastric cancer after fluoropyrimidine-based chemotherapy. Med Oncol 29, 100–106 (2012). https://doi.org/10.1007/s12032-010-9791-x

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