title: Feasibility study of adjuvant chemotherapy with S-1 (TS-1; tegafur, gimeracil, oteracil potassium) for gastric cancer.
abstract: BACKGROUND
  We conducted a feasibility study using S-1, a novel oral derivative of 5-fluorouracil, as postoperative adjuvant chemotherapy for curatively resected gastric cancer patients.
  
  
  METHODS
  Adjuvant chemotherapy consisted of eight courses (4-week administration and 2-week withdrawal) of S-1, at 80-120 mg/body per day. Forty-one patients from 11 institutions were enrolled in this pilot study, from November 1999 to October 2000.
  
  
  RESULTS
  Thirty-five patients were eligible. In 7 patients, S-1 administration was discontinued due to recurrence. Among the 28 patients without recurrence, the planned eight courses of S-1 were administered to 17 patients (60.7%). In 4 patients, S-1 administration was discontinued due to subjective symptoms, such as anorexia, in the first course. Adverse reactions such as neutropenia, leukopenia, elevated total bilirubin, anorexia, general fatigue, diarrhea, nausea, and stomatitis were seen in more than half of the patients. Although grade 3 neutropenia (29.3%), leukopenia (9.8%), and diarrhea (9.8%) were observed, no grade 4 adverse effects appeared. Compared with the treatment of unresectable or recurrent gastric cancer with S-1, the incidence of adverse reactions in the adjuvant setting was slightly higher, probably due to the influence of gastrectomy.
  
  
  CONCLUSIONS
  Except for the early development of anorexia, most likely due to adverse effects of surgery, postoperative administration of S-1 for 1 year seems feasible as adjuvant chemotherapy for gastric cancer.
authors.affiliation: Department of Surgical Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan.
authors.forename: Taira
authors.initials: T
authors.lastname: Kinoshita
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nashimoto
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Yamamura
authors.forename: Takeshi
authors.initials: T
authors.lastname: Okamura
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Sasako
authors.forename: Junichi
authors.initials: J
authors.lastname: Sakamoto
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kojima
authors.forename: Masahiro
authors.initials: M
authors.lastname: Hiratsuka
authors.forename: Kuniyoshi
authors.initials: K
authors.lastname: Arai
authors.forename: Motonori
authors.initials: M
authors.lastname: Sairenji
authors.forename: Norimasa
authors.initials: N
authors.lastname: Fukushima
authors.forename: Hironobu
authors.initials: H
authors.lastname: Kimura
authors.forename: Toshifusa
authors.initials: T
authors.lastname: Nakajima
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000601:surgery; D000328:Adult; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D004338:Drug Combinations; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010094:Oxonic Acid / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D011725:Pyridines / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D012449:Safety; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000601:surgery; D005641:Tegafur / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D000964:Antimetabolites, Antineoplastic; D004338:Drug Combinations; D011725:Pyridines; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid