Thompson C.,Lancaster University |
Thompson C.,Rosemere Cancer Center |
Joseph N.,General Hospital Polonnaruwa |
Sanderson B.,The Christie NHS Foundation Trust |
And 7 more authors.
International Journal of Radiation Oncology Biology Physics | Year: 2017
Purpose The aim of this study is to assess the tolerability of concurrent chemoradiation therapy with gemcitabine (GemX) in muscle invasive bladder cancer following neoadjuvant chemotherapy (neoGemX) by use of patient- and provider-reported outcomes. Methods and Materials Seventy-eight patients were treated with GemX. Thirty-eight received prior neoadjuvant chemotherapy (NAC). Patients were prospectively assessed during treatment and at 6 weeks and 12 months after treatment completion. Radiation therapy was given to a total dose of 52.5 Gy in 20 fractions with weekly concurrent gemcitabine chemotherapy, 100 mg/m2. Toxicity was assessed by the care provider and by a patient-reported outcome questionnaire collecting scores on the late effects in normal tissues–subjective, objective, management, and analytic scales and was statistically compared at baseline and 12 months, as well as between the neoGemX and GemX groups. Results The median duration of follow-up was 15.9 months. The radiation therapy completion rate was 95%, and 96% of patients completed at least 3 cycles of gemcitabine. Bowel toxicity of grade 3 or greater was reported in 7 of 38 patients (18%) in the neoGemX group and 5 of 25 (20%) in the GemX group. Three GemX and two neoGemX patients had grade 3 or greater urinary toxicity. Forty-nine patients completed questionnaires and were included in the analysis. Scores on the late effects in normal tissues–subjective, objective, management, and analytic scales showed an expected peak by week 4 of treatment. There was no statistically significant difference between mean scores at baseline and 12 months after treatment completion or between the neoGemX and GemX groups. Conclusions This study demonstrates that GemX, alone or following NAC, has manageable toxicity and acceptable treatment completion rates. Allowing for small patient numbers and the nonrandomized nature of this study, these results do not suggest any additional toxicity from the use of NAC prior to GemX. © 2017 Elsevier Inc.
PubMed | Rosemere Cancer Center
Type: Journal Article | Journal: Journal of clinical oncology : official journal of the American Society of Clinical Oncology | Year: 2016
1126 Background: Capecitabine is increasingly used in the treatment of metastatic breast cancer (MBC). We evaluated the use of capecitabine therapy (XT) in MBC at our centre, to determine factors that might predict response.We reviewed the records of patients (pts) with MBC who received XT, from February 05 to March 06. The duration of XT, whether use was continuous or intermittent, the line of use and concurrent treatments were evaluated. Response to XT was correlated to potential predicitve factors including age, tumour grade, estrogen receptor (ER) status and HER2 expression. Time to progression (TTP) and overall survival (OS) after XT were calculated.Seventy-two women received XT with a median age at initiation of 57 years. At diagnosis, 44% had grade 3 tumors. ER was positive in 61% and HER2 over-expressed in 33%. Adjuvant chemotherapy was given to 61% and adjuvant hormones to 54%. Median time to first relapse was 29 months (mths). XT was used commonly as 2nd- (26.4%) or 3rd-line (30.6%) treatment after relapse. XT was continuous in 83% and intermittent in 17%. Median number of XT cycles was 4 (range: 1-37). An objective response was noted in 23% and the overall clinical benefit rate was 43% (partial/good responses plus stable disease). The only positive correlation to predict response was ER positivity (p = 0.04). Common significant toxicity included grade 2, palmo-plantar erythema (22%) and fatigue (15%). In 22% a dose modification or delay was necessary. XT was stopped in 5 pts due to toxicity. Median OS after XT was 12 mths (95% CI 6.87-17.13) and median TTP on XT 3 mths (95% CI 2.07-3.93).XT remains an important palliative treatment option for patients with MBC. Patients with ER positive tumours respond better to XT. We did not identify any other factor that predicted response to XT. [Table: see text].