Low Dose Long-Term Capecitabine for Refractory Field Cancerization: A Retrospective Cohort Study.

Abstract

Topical-refractory cutaneous field cancerization is challenging to manage and distressing to patients. Evaluate the efficacy, toxicity, and patient satisfaction of long-term, low dose capecitabine for field cancerization. A retrospective cohort and survey study was performed at a single institution of patients treated with capecitabine for cutaneous field cancerization. Wilcoxon matched-pairs signed-rank test was used to compare annual keratinocyte carcinoma (KC) surgeries pre- and post-treatment at years 1, 2 and 3. 20 patients were treated over 20.8 months (range 0.8 - 57.5) including 8.0 months (0 - 33.1) of intervening treatment holidays. Mean KC surgeries decreased in all years of treatment compared to the year before treatment (1-year (n=18): 3.89 pre-capecitabine to 2.94, 24% reduction, p = 0.29; 2-year (n = 11): 3.46 pre-capecitabine to 0.93, 73% reduction, p = 0.02; 3-year (n = 5): 3.00 pre-capecitabine to 2.20, 27% reduction, p >0.99). Two patients (10%) discontinued therapy due to toxicity. Of 17 patients offered the survey, 12 responded (response rate 70.6%). A majority (75.0%) felt capecitabine improved their skin lesions at least moderately and 83.3% preferred capecitabine to alternative treatments.