Complete and sustained remission of refractory cervical cancer following a single cycle of capecitabine. A case report

Abstract

Cervical cancer with distant metastasis is almost always incurable. The treatment goal is to palliate the patient's symptoms with pain medications and localized radiation therapy. Chemotherapy generally has a limited role, with responses that are short lived. Newer agents investigated as potential therapy include fluorouracil prodrugs. We report on a case where capecitabine was used in metastatic cervical cancer with progression of disease outside the radiation field, following multiple drug regimens including one dose of cisplatin (discontinued due to transient renal toxicity), paclitaxel, and carboplatin and continuous infusion 5-fluorouracil (5-FU) The patient was treated with capecitabine 1100 mg/m2 twice daily for two weeks. After the first week of the cycle, the patient developed grade 2 toxicities consisting of mucositis and hand–foot Syndrome but she continued on therapy through day 14. On day 20 she was hospitalized with grade 4 toxicity, which included febrile neutropenia, urinary tract infection, pancytopenia, mucositis, hand–foot syndrome, and renal failure, all of which have subsequently completely resolved. Restaging demonstrated complete remission. Although the patient suffered toxicity related to capecitabine, 3.5 years post a single cycle of capecitabine, the patient remains in remission, with no evidence of disease reoccurence.