Low-dose long-term capecitabine for refractory field cancerization: A retrospective cohort study

Topical-refractory cutaneous field cancerization is challenging to manage and distressing to patients.

Evaluate the efficacy, toxicity, and patient satisfaction of long-term, low-dose capecitabine for field cancerization.

A retrospective cohort and survey study was performed at a single institution of patients treated with capecitabine for cutaneous field cancerization. Wilcoxon matched-pairs signed-rank test was used to compare annual keratinocyte carcinoma surgeries pre- and post-treatment at years 1, 2, and 3.

Twenty patients were treated over 20.8 months (range 0.8-57.5) including 8.0 months (0-33.1) of intervening treatment holidays. Mean keratinocyte carcinoma surgeries decreased in all years of treatment compared to the year before treatment (1-year (n = 18): 3.89 precapecitabine to 2.94, 24% reduction, P = .29; 2-year (n = 11): 3.46 precapecitabine to 0.93, 73% reduction, P = .02; 3-year (n = 5): 3.00 precapecitabine to 2.20, 27% reduction, P > .99). Two patients (10%) discontinued therapy due to toxicity. Of 17 patients offered the survey, 12 responded (response rate 70.6%). A majority (75.0%) felt capecitabine improved their skin lesions at least moderately and 83.3% preferred capecitabine to alternative treatments.

Retrospective design, small sample size.

Capecitabine reduces incident keratinocyte carcinomas and is well-tolerated long-term.