Toxicity of capecitabine compared with 5-fluorouracil in elderly patients with breast or gastrointestinal tract cancer

ABSTRACT

OBJECTIVES: The aim of this study was to evaluate the toxicity of capecitabine compared with 5-fluorouracil in elderly patients with breast or gastrointestinal tract cancer. MATERIAL AND METHODS: A cohort study was used to evaluate toxicity parameters in elderly patients undergoing chemotherapy treatment. This study was conducted between 2006 and 2008 and was composed of 76 patients from the Oncology Ambulatory of Hospital São Lucas, PUCRS. Eligible patients included elderly individuals (aged 60 years or above) of both sexes who suffered from breast or gastrointestinal tract cancer and who used daily oral capecitabine or intravenous 5-fluorouracil. General side effects were evaluated and graded on a four-point scale. The study also analyzed the values of blood markers such as alanine aminotransferase and aspartate aminotransferase for hepatic toxicity, and troponine I and electrocardiogram for cardiotoxicity. RESULTS: The data showed a higher frequency of general adverse effects in the patients who used 5-fluorouracil in relation of capecitabine. However, only the patients that used capecitabine suffered from hand-and-foot syndrome. Conversely, the levels of ALT in the elderly men who used capecitabine were significantly higher (p = 0.027) than those who used 5-fluorouracil. With regard to cardiac function, a significant difference (p = 0.023) in the median QT interval between the groups was found, while all the other exams presented normal results. CONCLUSION: The use of capecitabine should be frequently monitored in order to minimize or avoid the toxic effects of the chemotherapy in elderly patients. Other parameters should be subsequently analyzed to confirm this conclusion.