Background Capecitabine is indicated in colon cancer alone or in combination. Recommended posology is calculated with reference to the body surface area (BSA) and pharmacotherapeutic regimen, although adjustments can be made if drug-related toxicity occurs.
Purpose To describe the incidence of capecitabine dose adjustment in colon cancer patients (CCPs). To analyse the reasons for this adjustment.
Materials and Methods Retrospective observational study of 49 CCPs treated with capecitabine with at least 3 cycles of 14 days from June 2011 to February 2012. Data were collected from the dispensary and medical history. The severity of the toxicity was classified according to the CTCAEv.4.
Results Fourty-nine patients were enrolled: 25 male, average age of 61 (34–82), average BSA of 1.75 m². Most of them presented ECOG0 (26 patients) at the beginning of the treatment, followed by ECOG1 (18 patients). The average follow up was 4 months. Most of the patients were treated with capecitabine-oxaliplatin, followed by those treated with capecitabine monotherapy and other minority schemes (cyclophosphamide or bevacizumab). The median starting dose of capecitabine was 3300 mg.
32% of patients required a dose adjustment (delay and/or dose reduction) during the follow-up period. The treatment of 26% of patients was delayed by an average of 16 days (2 of the patients had to delay 2 cycles). The initial dose was reduced in 24% of patients (twice in three of the patients).
Toxicity in any grade was reported by 30% of the patients. Severe toxicities (grade 3 of CTCAE) were sickness and neutropenia. Most frequent toxicities were gastrointestinal side effects (6 patients) and grade 2 hand-foot syndrome (4 patients), followed by mucositis, skin side effects, hyperbilirubinaemia and thrombopenia.
Toxicity and dose adjustment were not statistically related to the treatment regimen, ECOG, gender or age.
Conclusions The toxicity profile was consistent with the trials. 81% of patients who had a dose adjustment didn’t need a further dose reduction.
No conflict of interest.
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