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    A phase I-II study of postoperative capecitabine-based chemoradiotherapy in gastric cancer.

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    Authors
    Jansen, Edwin P M
    Boot, Henk
    Saunders, Mark P
    Crosby, Tom D L
    Dubbelman, Ria
    Bartelink, Harry
    Verheij, Marcel
    Cats, Annemieke
    Affiliation
    Department of Radiotherapy of The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. epm.jansen@nki.nl
    Issue Date
    2007-12-01
    
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    Abstract
    BACKGROUND: The Intergroup 0116 randomized study showed that postoperative 5-fluorouracil-based chemoradiotherapy improved locoregional control and overall survival in patients with gastric cancer. We hypothesized that these results could be improved further by using a more effective, intensified, and convenient chemotherapy schedule. Therefore, this Phase I-II dose-escalation study was performed to determine the maximal tolerated dose and toxicity profile of postoperative radiotherapy combined with concurrent capecitabine. PATIENTS AND METHODS: After recovery from surgery for adenocarcinoma of the gastroesophageal junction or stomach, all patients were treated with capecitabine monotherapy, 1,000 mg/m2 twice daily for 2 weeks. After a 1-week treatment-free interval, patients received capecitabine (650-1,000 mg/m2 orally twice daily 5 days/week) in a dose-escalation schedule combined with radiotherapy on weekdays for 5 weeks. Radiotherapy was delivered to a total dose of 45 Gy in 25 fractions to the gastric bed, anastomoses, and regional lymph nodes. RESULTS: Sixty-six patients were treated accordingly. Two patients went off study before or shortly after the start of chemoradiotherapy because of progressive disease. Therefore, 64 patients completed treatment as planned. During the chemoradiotherapy phase, 4 patients developed four items of Grade III dose-limiting toxicity (3 patients in Dose Level II and 1 patient in Dose Level IV). The predefined highest dose of capecitabine, 1,000 mg/m2 twice daily orally, was tolerated well and, therefore, considered safe for further clinical evaluation. CONCLUSIONS: This Phase I-II study shows that intensified chemoradiotherapy with daily capecitabine is feasible in postoperative patients with gastroesophageal junction and gastric cancer.
    Citation
    A phase I-II study of postoperative capecitabine-based chemoradiotherapy in gastric cancer. 2007, 69 (5):1424-8 Int. J. Radiat. Oncol. Biol. Phys.
    Journal
    International Journal of Radiation Oncology, Biology, Physics
    URI
    http://hdl.handle.net/10541/71018
    DOI
    10.1016/j.ijrobp.2007.05.004
    PubMed ID
    17689023
    Type
    Article
    Language
    en
    ISSN
    0360-3016
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.ijrobp.2007.05.004
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