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.