Combined S-1 and cisplatin preoperative chemotherapy for patients with advanced gastric cancer: report of five cases.
OBJECTIVE
A high response rate with acceptable toxicities is required in the setting of neoadjuvant chemotherapy. Five cases (3 stage IV, 2 stage IIIb) of advanced gastric cancer were successfully treated by neoadjuvant chemotherapy consisting of a combination of S-1 and cisplatin.


METHODS
All 5 patients were men younger than age 60, with no severe complications. S-1 was administered orally (80 mg/m2/day) twice daily for 21 consecutive days, and cisplatin (60 mg/m2) was infused over 2 hours on day 8 with hydration. This schedule was repeated every 5 weeks. After each cycle, the clinical response evaluation was performed with endoscopy, barium meal, and spiral CT scan. Surgery was carried out about 3 weeks after chemotherapy.


RESULTS
All patients were responders (100%) after one or two cycles. However, there was no patient with either complete response, or down-staging. Toxicities, according to the WHO criteria, were very mild and none required treatment. Postoperatively one patient died of aspiration pneumonia unrelated to the chemotherapy. The others were discharged within 3 weeks after operation without complications.


CONCLUSIONS
S-1 plus cisplatin seems safe and effective as neoadjuvant chemotherapy in advanced gastric cancer patients.
Nakane
Yasushi
Y
Second Department of Surgery, Kansai Medical University, Moriguchi, Osaka, Japan. nakaney@takii.kmu.ac.jp
Inoue
Kentaro
K
Michiura
Taku
T
Nakai
Koji
K
Sato
Mutuya
M
Baden
Tetuya
T
Okumura
Shunichiro
S
Yamamichi
Keigo
K
D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage*; D004338:Drug Combinations; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D010094:Oxonic Acid / Q000008:administration & dosage*; D011725:Pyridines / Q000008:administration & dosage*; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000601:surgery*; D005641:Tegafur / Q000008:administration & dosage*
D000964:Antimetabolites, Antineoplastic; D004338:Drug Combinations; D011725:Pyridines; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D002945:Cisplatin