A pilot study of combination chemotherapy with S-1 and low-dose cisplatin for highly advanced gastric cancer.
BACKGROUND
The surgical outcome for advanced gastric cancer, even following curative surgery, is associated with a poor prognosis. A pilot study in advanced gastric cancer patients was carried out using pre-operative chemotherapy with S-1 and low-dose cisplatin (CDDP) (TSLD).


METHODS
Twenty-one patients with stage IV gastric cancer were treated with TSLD as the initial treatment, after informed consent had been obtained. Surgery was performed when curative resection was deemed feasible in selected patients who showed improvement in their tumors. Other regimens including CPT-11 or taxanes were utilized as second-line chemotherapy when the tumor showed no change or progressive disease following TSLD therapy.


RESULTS
No patient had a complete response, while 11 had partial responses following TSLD therapy, yielding an overall response rate of 52.4%. Fifteen out of 21 (71.4%) underwent surgery following TSLD therapy, while curative surgery determined by histological investigation was performed in 10 out of 15 (47.6%) patients. No grade 4 toxicities or treatment-related deaths were observed. The following grade 3 toxicities were observed: neutropenia (6 patients), thrombocytopenia (1 patient) and anemia (1 patient). The other toxicities observed, including gastrointestinal toxicity, were grade 2 or less. The median survival time of all patients was 526 days, and 1- and 2-year survival rates were 64.9% and 41.7%, respectively.


CONCLUSIONS
TSLD is a potent regimen with a low toxicity profile for highly advanced gastric cancer.
Takahashi
Tsunehiro
T
Department of Surgery, School of Medicine, Keio University, Tokyo 160-8582, Japan.
Saikawa
Yoshiro
Y
Yoshida
Masashi
M
Kitagawa
Yuko
Y
Otani
Yoshihide
Y
Kubota
Tetsuro
T
Kumai
Koichiro
K
Kitajima
Masaki
M
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D004338:Drug Combinations; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010094:Oxonic Acid / Q000008:administration & dosage / Q000009:adverse effects; D010865:Pilot Projects; D011725:Pyridines / Q000008:administration & dosage / Q000009:adverse effects; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000473:pathology; D005641:Tegafur / Q000008:administration & dosage / Q000009:adverse effects
D004338:Drug Combinations; D011725:Pyridines; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D002945:Cisplatin