Radiological Response to Capecitabine and Temozolomide in an Elderly Patient with Metastatic Leiomyosarcoma: A Case Report
Journal of Clinical Medicine, cilt.15, sa.17, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 15 Sayı: 17
- Basım Tarihi: 2026
- Doi Numarası: 10.3390/jcm15176668
- Dergi Adı: Journal of Clinical Medicine
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Chemical Abstracts Core, EMBASE, Academic Search Ultimate (EBSCO), Health Research Premium Collection (ProQuest)
- Anahtar Kelimeler: capecitabine, case report, elderly, leiomyosarcoma, metastatic, second-line chemotherapy, soft-tissue sarcoma, temozolomide
- Hacettepe Üniversitesi Adresli: Evet
Özet
Metastatic leiomyosarcoma (LMS) is characterized by limited treatment options beyond first-line therapy, and cross-resistance among cytotoxic agents is often assumed to exist. However, differential sensitivity to distinct chemotherapy mechanisms may exist. We report the case of an 81-year-old woman diagnosed with metastatic LMS of unknown primary origin presenting with extensive hepatic and pulmonary involvement. Following eight cycles of first-line gemcitabine plus docetaxel, the patient achieved stable disease without objective tumor shrinkage. Given this limited response, a significant radiological response to subsequent therapy was not anticipated. Second-line oral capecitabine and temozolomide (CAPTEM) was initiated, resulting in a marked radiologic regression at four months, with reductions in hepatic metastases and pulmonary nodules and no new lesions. Treatment was well tolerated, with no grade 3–4 toxicities. This case demonstrates a differential response to gemcitabine-based therapy and sensitivity to alkylating agents in LMS, supporting a more individualized, mechanism-driven treatment sequencing approach.