Concurrent capecitabine and whole-brain radiotherapy for treatment of brain metastases in breast cancer patients
Concurrent capecitabine and whole-brain radiotherapy for treatment of brain metastases in breast cancer patients
复制标题
DOI：
10.1007/s11060-008-9791-2
复制
发表时间：
2009-07-01
影响因子：
3.9
通讯作者：
Fourquet, Alain
中科院分区：
文献类型：
--
作者：
Chargari, Cyrus;Kirova, Youlia M.;Fourquet, Alain
临床前数据已经证明电离辐射与卡培他滨协同作用。本报告回顾性评估了卡培他滨联合全脑放疗（WBRT）治疗乳腺癌脑转移患者的疗效。从2003年1月至2005年3月，5例伴有脑转移的乳腺癌患者被转诊接受WBRT，同时接受卡培他滨治疗。中位年龄为44岁（范围：38-53岁）。卡培他滨的中位剂量为1，000 mg/m2，每日两次，持续14天（第1 -14天）。每21天重复治疗周期，同时进行WBRT（30戈伊，每次3戈伊，每周5天）。开始WBRT加卡培他滨治疗后的中位生存期为6.5个月（范围1-34个月）。1例患者获得完全缓解。2例患者获得部分缓解，其中1例局部控制持续至最近随访。一名患者病情稳定。其余1例患者因早期死亡而无法评估缓解。最常报告的不良事件为恶心（n = 2）和头痛（n = 2），均为1级。其他毒性为3级手/足综合征（n = 1）、需要输血和卡培他滨剂量减少的中度贫血（n = 1）和1级粘膜炎（n = 1）。虽然有希望，这些初步的数据值得进一步评估卡培他滨为基础的化疗放射治疗乳腺癌脑转移，需要进一步验证的临床试验的设置。
Preclinical data have demonstrated that ionizing radiation acts synergistically with capecitabine. This report retrospectively assessed the use of capecitabine concurrently with whole-brain radiotherapy (WBRT) in patients with brain metastases from breast cancer. From January 2003 to March 2005, five breast cancer patients with brain metastases were referred for WBRT with concurrent capecitabine. Median age was 44 years (range: 38-53). The median dose of capecitabine was 1,000 mg/m(2) twice daily for 14 days (day1-14). Treatment cycles were repeated every 21 days, concurrently with WBRT (30 Gy, 3 Gy per fraction, 5 days per week). Median survival after starting WBRT plus capecitabine was 6.5 months (range 1-34 months). One patient achieved a complete response. Two patients achieved partial response, including one with local control lasting until most recent follow-up. One patient had stable disease. The remaining patient was not assessable for response because of early death. Most commonly reported adverse events were nausea (n = 2) and headache (n = 2), always grade 1. Other toxicities were grade 3 hand/foot syndrome (n = 1), moderate anemia requiring transfusion and dose reduction of capecitabine (n = 1), and grade 1 mucositis (n = 1). Although promising, these preliminary data warrant further assessment of capecitabine-based chemoradiation in brain metastases from breast cancer and need to be further validated in the setting of a clinical trial.