Metronomic Capecitabine for Elderly Advanced Gastric Carcinoma Patients Pretreated With One or Two Systemic Chemotherapy Lines

Background: The aim of this study was to investigate the efficacy and safety of metronomic capecitabine chemotherapy in pretreated elderly patients with advanced gastric carsonoma. Patients and Methods: Eligible patients were treated with capecitabine at a fixed dose of 1000mg daily until disease progression or toxicity. Endpoints were overall response rate, safety, progression-free survival and overall survival. Results: Thirty eight patients were enrolled (June 2004 to October 2011) with a median age of 69 years. Two patients refused continuation due to deterioration of general condition consequently, 36 out of 38 patients were assessed for response. No complete response was observed while 6 patients out of 36 patients (16.7%) achieved partial response, 13 (36.1%) showed stable disease and 17 (47.2%) showed progression of disease. The disease control rate (response rate + stability rate) was 52.8%. The most common hematologic adverse effects were neutropenia in 3 (8.3%), followed by mucositis in 2 (5.6%) patients. There was one reported case of neutropenic fever. The reported hand-foot syndrome cases were all lower than grade 3. There were no treatment-related deaths and treatment delays were observed in 8 patients. Symptomatic improvement was evident in 18 patients (50 %). Median follow-up period was 6.5 months. Median time to progression was 3 months (range: 0 to7 months), while the median overall survival was 7 months (range: 3 to15 months). Conclusion: Metronomic capecitabine may be considered an effective and tolerable treatment option in elderly patients with pretreated advanced gastric cancer after the failure of previous lines of chemotherapy. Key words: Metronomic, capecitabine, gastric, cancer, elderly.