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Capecitabine for locally advanced and metastatic colorectal cancer:A review

World Journal of Gastrointestinal Oncology 2010年第8期2卷 311-321页

作者： georgios V Koukourakis georgios zacharias John Tsalafoutas Dimitrios Theodoridis Vassilios Kouloulias Department of Radiation Oncology Anticancer Institute of Athens "Saint Savvas" Section of Intensive Therapy General Hospital of Corinth Department of Radiation Physics Anticancer Institute of Athens "Saint Savvas" Department of Laboratory Medicine "Saint Olga" General Hospital of Athens Section of Radiation Oncology University Hospital of Athens "ATTIKON"

Capecitabine (Xeloda) is an oral fluoropyrimidine which is produced as a pro-drug of fluorouracil, and shows improved tolerability and intratumor drug concentrations following its tumor-specif ic conversion to the active drug. We have searched the Pubmed and Cochrane databases from 1980 to 2009 with the purpose of reviewing all available information on Capecitabine, focusing on its clinical effectiveness against colorectal cancer. Special attention has been paid to trials that compared Capecitabine with standard folinic acid (leucovorin, LV)-modulated intravenous 5-fluorouracil (5-FU) bolus regimens in patients with metastatic colorectal cancer. Moreover the efficacy of Capecitabine on metastatic colorectal cancer, either alone or in various combinations with other active drugs such as Irinotecan and Oxaliplatin was also assessed. Finally, neoadjuvant therapy con- sisting of Capecitabine plus radiation therapy, for locally advanced rectal cancer was analysed. This combination of chemotherapy and radiotherapy has a special role in tumor down staging and in sphincter preservation for lower rectal tumors. Comparative trials have shown that Capecitabine is at least equivalent to the standard LV-5-FU combination in relation to progression-free and overall survival whilst showing a better tolerability prof ile with a much lower incidence of stomatitis. It is now known that Capecitabine can be combined with other active drugs such as Irinotecan and Oxaliplatin. The combination of Oxaliplatin with Capecitabine represents a new standard of care for metastatic colorectal cancer. Combinating the Capecitabine-Oxaliplatin regimen with promising new biological drugs such as Bevacizumab seems to give a realistic prospect of further improvement in time to progression of metastatic disease. Moreover, preoperative chemo-radiation using oral capecitabine is better tolerated than bolus 5-FU and is more effective in the promotion of both down-staging and sphincter preservation in patie

关键词： Chemo-radiotherapy Colorectal cancer Capecitabine Oxaliplatin Xeloda

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