Comparison of 5-FU vs capecitabine in combination with mitomycin or cisplatin in the treatment of anal cancer.
Bibliographic record
Abstract
3576 Background: The patterns of capecitabine use as an alternative form of fluoropyrimidine to infusional 5-FU in the non-operative management of anal cancer in the real world are poorly described. Our objectives were to determine the frequency of capecitabine use, compare the observed outcomes between oral and intravenous fluoropyrimidines, and examine for variations in treatment-related adverse events between the two agents. Methods: All anal cancer patients who received either capecitabine or infusional 5-FU as part of their chemoradiation treatment from 2004 to 2013 at any 1 of 6 cancer centers in British Columbia were included. Chi-square and Wilcoxon-Mann tests were used to assess for associations between treatment groups and clinical characteristics and outcomes. Results: A total of 486 patients were identified: median age was 59 (IQR 53-67) years, 175 (36%) were men, 418 (86%) had ECOG 0/1, and 30 (6%) were HIV positive. Median total radiation dose was 54 cGy (IQR 50-54) and 47 (10%) underwent a colostomy prior to chemoradiation. Baseline characteristics were balanced between the two groups with respect to age, gender, ECOG, and HIV status (all p > 0.05). Prior to 2010, only 5-FU was utilized. From 2010 to 2013, 155 and 82 patients (65% vs 35%) received capecitabine vs 5-FU, respectively. Overall (68% vs 67%, p = 0.831) and disease-free survival rates (59% vs 59%, p = 0.926) at 3 years were similar in the capecitabine vs 5-FU groups. Rates of subsequent abdomino-perineal resection were also similar (10% vs 14%, p = 0.164). Patients who received 5-FU were more likely to report adverse effects (76% vs 57%, p < 0.01). The capecitabine group had a lower incidence of stomatitis (7% vs 43%, p < 0.01) whereas the 5-FU cohort reported less frequent hand-foot syndrome (1% vs 7%, p < 0.01). The rates of myelosuppression, nausea/vomiting, diarrhea, and rash were similar between the two groups (all p > 0.05). Conclusions: This represents one of the largest population-based studies to demonstrate a preference for capecitabine in place of 5-FU in the management of anal cancer. Survival outcomes were similar between the two treatment groups, but capecitabine may be better tolerated in the real world.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".