Concurrent Capecitabine and Radiation Therapy for High-risk Primary Breast Cancer

Abstract

Introduction: Data is limited for concurrent capecitabine-radiotherapy (CCRT) in primary breast cancer. We evaluated outcomes and toxicities of patients at high risk of locoregional recurrence receiving adjuvant CCRT. Methods: Ten non-metastatic breast cancer patients receiving concurrent treatment were reviewed retrospectively. Capecitabine was given during and after radiation. Toxicity was reviewed using weekly on-treatment visit and follow-up notes. Results: All patients had stage II-III disease. Four patients had grade 3 skin toxicity during radiation. Capecitabine and RT-related toxicity breaks occurred for 5 and 0 patients, respectively. At 1-month follow-up, 9 patients recovered from acute toxicities sufficiently to start adjuvant capecitabine. At 25 months median follow-up, 1 patient had synchronous local recurrence and distant metastasis (DM), while 3 patients had DM only. Conclusions: Use of CCRT for breast cancer was associated with significant acute grade 3 dermatitis, however, all patients successfully completed their radiation course without interruption.

Capecitabine Efficacy With Adjuvant Radiotherapy in the Treatment of Early Stage Breast Cancer (Retrospective Study)

“…Skin fibrosis G1 was observed in 12.5% of our patients in our study, and the DFS was 62.5% in patients with tumor stage III, which is inconsistent with Goyal et al 24 , in which skin fibrosis was reported in 22.2% of cases, and the 2 year distant recurrence free survival (DRFS) was 75%; this difference can be explained by our study's longer follow up.…”

“…In our study, no cases developed LRR during the follow-up period, and 6 patients developed distant metastases (15%), which is consistent with the results of Alhanafy et al in which 6 patients (12%) developed distant metastases (12%) and one patient developed LRR during the 2 year follow-up period 26 , while in Panoff et al 4 patients (20%) developed distant metastases and no LRR was documented 24 .…”

“…In our study Skin fibrosis G1 was observed in 12.5 % of our patients and the DFS was 62.5 % in patients with tumor stage III, which is incompatible with Goyal et al in which the skin fibrosis was reported in 22.2% of cases, the 2 year distant recurrence free survival (DRFS) was 75%, this difference can be explained by longer follow up of our study.Goyal et al is a retrospective study evaluating the toxicity of combining capecitabine with RT in patients with high risk of LRR.Capecitabine was given at a dose 1000 mg po twice aday 2 cycles during RT and 4 cycles after finishing RT, RT was given in a dose of 45-50.4Gy in 1.8-2Gy daily fractions to the chest wall or breast and regional lymph nodes 24 .…”

“…In addition, a boost dose of 14 Gy administered in 7 fractions was added to the lumpectomy bed. Results: Study group were evaluated at 3,12,24, 36, 48, and 60 months. At 3 and 12 months, 29 patients (61.7%) exhibited G1 skin hyperpigmentation.…”