Pharmacokinetics of S-1 in patients with peritoneal dissemination of gastric cancer.
The response of gastric cancer with peritoneal dissemination to systemic chemotherapy may be negatively affected by poor drug delivery due to the blood-peritoneal barrier. However, S-1 has been reported to be effective. We examined the pharmacokinetics of S-1 in 14 patients who had gastric cancer with peritoneal dissemination. S-1 was given from the morning of the day before surgery to the morning of surgery. Concentrations of 5-fluorouracil (5-FU) and gimeracil (CDHP) were measured in the serum, ascites, disseminated peritoneal nodes, and normal peritoneum. There was a strong correlation between 5-FU and CDHP concentrations in peritoneal tissues. The concentrations of 5-FU and CDHP in the serum were similar to those in ascites. The concentration of 5-FU was significantly higher in disseminated nodes than in the normal peritoneum. After administration of S-1 to gastric cancer patients with peritoneal dissemination, 5-FU and CDHP in the serum linearly pass through the peritoneum and enter the ascites. High concentrations of 5-FU selectively penetrate disseminated peritoneal cells.
Oshima
Takashi
T
Gastroenterological Center, Yokohama City University Medical Center, Yokohama 232-0024, Japan. ohshimatakashi@yahoo.co.jp
Yamada
Roppei
R
Hatori
Shinsuke
S
Kunisaki
Chikara
C
Imada
Toshio
T
D000328:Adult; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000097:blood / Q000493:pharmacokinetics*; D001682:Biological Availability; D004338:Drug Combinations; D005260:Female; D005472:Fluorouracil / Q000097:blood / Q000493:pharmacokinetics; D006801:Humans; D008198:Lymph Nodes / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010094:Oxonic Acid / Q000097:blood / Q000493:pharmacokinetics*; D010534:Peritoneal Neoplasms / Q000378:metabolism* / Q000556:secondary; D010537:Peritoneum / Q000378:metabolism; D011725:Pyridines / Q000097:blood / Q000493:pharmacokinetics; D013274:Stomach Neoplasms / Q000378:metabolism* / Q000473:pathology; D005641:Tegafur / Q000097:blood / Q000493:pharmacokinetics*
D000964:Antimetabolites, Antineoplastic; D004338:Drug Combinations; D011725:Pyridines; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D005472:Fluorouracil; C104201:gimeracil