Purpose/Objective: Background: To determine the efficacy of pyroxidine (vitamin B6) administration in the reduction of symptoms from the use of capecitabine (xeloda) in conjunction with RT for treatment of pancreatic and upper gastrointestinal tract tumors. The specific aims of this study were to evaluate the reduction of skin toxicities, particularly hand-foot syndrome after treatment with pyroxidine and oral capecitabine. Materials/Methods: Patients and Methods: A retrospective analysis of twelve patients (pts) age 47-83 yrs old treated with a regimen of capecitabine 825mg/m2 administered PO twice daily (1,500mg/m2/d, except one pt whose dose was 2,000mg/m2/d) who received concomitant oral pyroxidine of either 50mg TID (5 pts) or 100mg TID (7 pts). The disease site breakdown of the population reviewed consisted of pancreas (9 pts), cholangiocarcinoma (2 pts), and gastric (1 pt). Adverse reactions were monitored throughout the treatment course which averaged 5.5 weeks. Results: Results: At a median follow-up time of 15 weeks, two pts (16%) experienced a maximum grade 2 skin toxicity specific for hand-foot syndrome. One pt (8 %) experienced grade 1 skin toxicity categorized as hand-foot syndrome. Among the three pts with hand-foot syndrome, 2/3 received 50mg three times daily and 1/3 received 100mg daily. All pts experiencing hand-foot syndrome were male. Conclusions: Conclusion: Our preliminary experience with the upfront use of pyroxidine in conjunction with capecitabine resulted in clinically beneficial effects on the reduction of skin toxicity/hand-foot syndrome. While this series is numerically small and pre-emptive generalization of such results is unwarranted, the favorable toxicity profile of pyroxidine makes implementation in this population an attractive therapeutic adjunct if this data proves reliable. Patients tolerated the pyroxidine well and further evaluation of the advantages of prophylactic pyroxidine with capecitabine in other patient populations should be considered in the design of future clinical trials.
Joyner, M,
Prophylactic Concomitant Pyroxidine Administration with Capecitabine (Xeloda) in the Treatment of Upper Gastrointestinal Tract Adenocarcinoma Receiving Radiation Therapy (RT) Ameliorates Hand-Foot Syndrome: Preliminary Experience from the San Antonio Cancer Institute. Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL.
http://archive.rsna.org/2005/4420669.html
