Can Capecitabine be used Instead of Concurrent Bolus 5-FU in Postoperative Chemoradiotherapy for Gastric Adenocarcinoma?

Background: 5-fluoro-uracil (FU) is a common agent in postoperative chemoradiation in gastricadenocarcinoma. However, FU is not well tolerated in a significant proportion of patients. Capecitabine (CA) isan orally administered fluoropyrimidine carbamate which is preferentially converted to active 5-FU and is oneof the agents used instead of FU in such cases. We compared the toxicity, local and distant control and survivalrates with FU or oral CA during the course of concurrent radiotherapy to assess the role of CA used instead ofFU. Materials and
Methods: We conducted an analysis of survival, disease control and toxicity data in 46 patientstreated with postoperative chemoradiation following total or subtotal gastrectomy for gastric adenocarcinomawith either FU or CA between January 2008 and December 2012.
Results: Median follow-up was 19 months(range: 3-59), median survival time was 23 (±6.08) months and 1-3 years overall survival (OS) rates were 64.9-39% for all patients. Compared with the CA regimen, the incidence of treatment interruption was higher withFU (p=0.023), but no significant differences were seen in local control (p=0.510), distant recurrences (p=0.721)and survival rates (p=0.866) among patients.
Conclusions: Concurrent CA with radiotherapy seems to be a moretolerable and an equally effective regimen for the postoperative treatment of gastric adenocarcinoma whencompared to FU.