Concurrent capecitabine with external beam radiotherapy versus radiotherapy alone in painful bone metastasis of breast cancer origin,Journal of Bone Oncology

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Concurrent capecitabine with external beam radiotherapy versus radiotherapy alone in painful bone metastasis of breast cancer origin
Journal of Bone Oncology ( IF 3.1 ) Pub Date : 2021-10-16 , DOI: 10.1016/j.jbo.2021.100395
Shimaa Ahmed ₁ , Shereen M Kamal ₂ , Tareq Salah ₃ , Mayada Fawzy Sedik ₄ , Ayatallah A Youssief ₁

Affiliation

Background

In breast cancer, painful bone metastases are common. Local radiotherapy is the standard treatment of painful bone metastases. Pain control and overall response rateswere low in radiotherapy alone.

The objectives of this study were to compare the safety and efficacy of external beam radiotherapy with concurrent capecitabine vs. external beam radiotherapy alone in pain control of painful bone metastases in breast cancer patients.

Materials and methods

Eighty-four patients with painful bone metastases from breast cancer participated in this prospective study. We randomized the patients into two groups: group A treated with radiotherapy 30 Gy in 10 fractions and group B treated with capecitabine 825 mg/m² every 12 hrs. concurrently with the same radiotherapy dose.

Results

There was no statistically significant difference between the two groups regarding early treatment toxicity. Most of the toxicity was gastrointestinal (diarrhea and nausea) and mild (grade I or II). The median pain score decreased from week one, and there was a marked response at week4. The difference in median pain score between both groups was statistically significant with p-value = 0.045. The median analgesic score in both groups was statistically significant with a p-value = 0.032 at week 12. A complete response to pain at week 4 was 19% and 42.9% in groups A and B, respectively.

Conclusion

Concurrent chemoradiation in painful bone metastases from breast cancer origin was tolerable and safe; it had a higher overall response rate and pain palliation than radiotherapy alone.

中文翻译：

卡培他滨联合外照射放疗与单独放疗治疗乳腺癌来源的疼痛性骨转移的比较

背景

在乳腺癌中，疼痛的骨转移很常见。局部放射治疗是疼痛性骨转移的标准治疗方法。单独放疗的疼痛控制和总体缓解率较低。

本研究的目的是比较外照射放疗联合卡培他滨与单独外照射放疗在控制乳腺癌患者骨转移疼痛方面的安全性和有效性。

材料和方法

84 名乳腺癌骨转移患者参与了这项前瞻性研究。我们将患者随机分为两组：A 组接受 30 Gy 放射治疗，分 10 次治疗，B 组每 12 小时接受卡培他滨 825 mg/m ²治疗。同时进行相同剂量的放射治疗。

结果

两组之间的早期治疗毒性没有统计学上的显着差异。大多数毒性是胃肠道毒性（腹泻和恶心）和轻度毒性（I 级或 II 级）。中位疼痛评分从第一周开始下降，第四周出现明显反应。两组之间的中位疼痛评分差异具有统计学意义，p 值 = 0.045。第 12 周时，两组的中位镇痛评分均具有统计学显着性，p 值 = 0.032。第 4 周时，A 组和 B 组对疼痛的完全缓解率分别为 19% 和 42.9%。