title: A case of suspected vasospastic angina related to S-1 administration.
abstract: A 58-year-old male with advanced gastric cancer underwent a total gastrectomy after neoadjuvant chemotherapy with paclitaxel and cisplatin. The combination chemotherapy was resumed postoperatively as adjuvant chemotherapy. Although no recurrence was observed after 6 months of adjuvant chemotherapy,the patient elected to receive further adjuvant chemotherapy with an oral drug. On the night of November 9,2006, he began taking S-1 at a dose of 50 mg twice daily. Fifty minutes after taking the first 50 mg of S-1,he experienced a squeezing chest pain at rest that was later accompanied by diaphoresis and nausea. The pain continued for approximately one hour,but had subsided by the time he reached an emergency room. Coronary angiography revealed a 50% eccentric stenosis in the proximal site of the right coronary artery,but there was no coronary lesion which could caused myocardial ischemia. Cardiac scintigraphy using 123I-BMIPP (123I-labeled beta-methyl-p-iodophenyl-pentadecanoic acid) showed a decreased uptake of BMIPP within the posterior wall,which improved one month later,so transient myocardial ischemia was confirmed. Since vasospastic angina related to S-1 administration was highly suspected,re-administration of S-1 was not performed. The patient is not currently receiving chemotherapy and remains under surveillance for relapse.
authors.affiliation: Dept. of Medical Oncology, Misawa City Hospital, Misawa, Aomori, Japan.
authors.forename: Kohei
authors.initials: K
authors.lastname: Shitara
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Kameda
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Hoshi
authors.forename: Masaki
authors.initials: M
authors.lastname: Munakata
authors.forename: Osamu
authors.initials: O
authors.lastname: Muto
authors.forename: Yuh
authors.initials: Y
authors.lastname: Sakata
mesh_terms: D000788:Angina Pectoris, Variant / Q000139:chemically induced* / Q000000981:diagnostic imaging; D000964:Antimetabolites, Antineoplastic / Q000009:adverse effects*; D017024:Chemotherapy, Adjuvant; D003329:Coronary Vasospasm / Q000139:chemically induced*; D004338:Drug Combinations; D005227:Fatty Acids; D006801:Humans; D007462:Iodobenzenes; D008297:Male; D008875:Middle Aged; D010094:Oxonic Acid / Q000009:adverse effects*; D011877:Radionuclide Imaging; D013274:Stomach Neoplasms / Q000628:therapy; D005641:Tegafur / Q000009:adverse effects*
chemical_list: D000964:Antimetabolites, Antineoplastic; D004338:Drug Combinations; D005227:Fatty Acids; D007462:Iodobenzenes; C049338:iodofiltic acid; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid