© The Author (2008). Published by Oxford University Press. All rights reserved
Capecitabine Monotherapy for Recurrent and Metastatic Nasopharyngeal Cancer
1 Department of Clinical Oncology, The University of Hong Kong, Queen Mary Hospital, Hong Kong SAR
2 Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China
For reprints and all correspondence: Daniel Chua, Department of Clinical Oncology, PB-115, Queen Mary Hospital, Pokfulam, Hong Kong, China. E-mail: dttchua{at}hkucc.hku.hk
Received December 27, 2007; accepted February 22, 2008
Background: Capecitabine monotherapy had activity in recurrent/metastatic nasopharyngeal carcinoma (NPC) as demonstrated previously in a small pilot study. We conducted a retrospective review of patients who received capecitabine for recurrent and metastatic NPC to further evaluate its clinical benefits.
Methods: Forty-nine patients with recurrent and metastatic NPC received capecitabine at a dose of 1–1.25 G/m2 twice daily for 14 days in 3-week cycles. Disease sites were locoregional in 29%, distant in 45% and locoregional plus distant in 26%. All except one had prior platinum-based chemotherapy for relapse or as adjunctive treatment. Median follow-up was 10 months (range: 3–41).
Results: Treatment was generally well tolerated. Hand-foot syndrome was common and occurred in 86% (25% Grade 3). Grade 3 hematological toxicity occurred in 6%. Partial response rate was 31% (95% CI: 18%, 44%) and complete response rate was 6% (95% CI: 0%, 13%), for an overall response rate of 37% (95% CI: 23%, 50%). Median time-to-progression was 5 months and median survival was 14 months. One- and two-year survival rates were 54 and 26%, respectively. Significantly better survival was observed in patients treated for locoregional recurrence and those with severe hand-foot syndrome.
Conclusions: Capecitabine has single agent activity in NPC and severe hand-foot syndrome predicts favorable outcome. Based on our experience, capecitabine monotherapy should be considered in patients with recurrent/metastatic NPC.
Key Words: nasopharyngeal carcinoma • capecitabine • hand-foot syndrome • palliative chemotherapy