Efficacy comparison of capecitabine metronomic chemotherapy and conventional chemotherapy in the maintenance of elderly patients with metastatic breast cancer

Abstract

Objective To investigate the clinical efficacy of capecitabine metronomic chemotherapy in the maintenance of elderly patients with metastatic breast cancer. Methods Fifty-six patients with metastatic breast cancer treated in Jiangsu Shengze Hospital from April 2014 to April 2017 were randomly divided into two groups according to random number table method: metronomic chemotherapy group (n = 28) and conventional chemotherapy group (n = 28). The patients in the metronomic chemotherapy group were treated with capecitabine 500 mg, 2 times/d and continuous oral administration. The conventional chemotherapy group received capecitabine 1 250 mg, 2 times/d for 14 days, rested for 7 days, 21 days was a course of treatment. After two courses, the clinical efficacy, toxicity and quality of life were evaluated. Results There were no significant differences in RR and DCR between the metronomic chemotherapy group and conventional chemotherapy group (RR: 39.3% vs. 42.8%, DCR: 89.3% vs. 85.7%, both P > 0.05). The median progression-free survival (PFS) time in the metronomic chemotherapy group was 5.8 months (95% CI 3.23-7.44, P = 0.764) and median overall survival (OS) time was 7.9 months (95% CI 4.15-7.95, P = 0.519). The median PFS time in the conventional chemotherapy group was 7.2 months (95% CI 3.32-6.33, P = 0.835), median OS time was 10.3 months (95% CI 4.08-7.37, P = 0.463). There was no significant difference between the two groups (both P > 0.05). The incidences of hand-foot syndrome, myelosuppression and digestive tract reaction in conventional chemotherapy group were higher than those in metronomic chemotherapy group, there were significant differences between the two groups (all P < 0.05). No Ⅲ- Ⅳ level adverse reactions were found in the metronomic chemotherapy group. The overall rate of improvement of the quality of life in the metronomic chemotherapy group was significantly higher than that in the conventional chemotherapy group (92.9% vs. 78.8%, χ2 = 7.629, P < 0.05). Conclusion The clinical efficacy of capecitabine metronomic chemotherapy in the maintenance of elderly patients with metastatic breast cancer is similar to conventional dose maintenance therapy, but it can not only reduce the side effects, but also improve the quality of life of patients. Key words: Breast neoplasms; Neoplasm metastasis; Capecitabine; Metronomic chemotherapy; Maintenance therapy