title: [A partial response to S-1 as second-line chemotherapy in a patient with unresectable pancreatic cancer].
abstract: A male in his fifties presented with a primary complaint of abdominal distension and appetite loss. CT revealed a primary pancreatic tumor with massive ascites. The patient was treated with gemcitabine as the first-line chemotherapy. Gemcitabine (1,000 mg/m2) was intravenously administered 3 times (on days 1, 8, 15) every 4 weeks (days 1-28) as 1 course. CT revealed the size of the primary tumor to decrease and no ascites were observed. A new abdominal lesion appeared after 11 courses of gemcitabine. The time to progression was 11 months after the first-line chemotherapy. The patient was then treated with S-1 as second-line chemotherapy. S-1 (80 mg/m2) was orally administered daily for 4 weeks (days 1- 28) every 6 weeks. CT thereafter revealed a partial response. The patient experienced no adverse events. The time to progression was 6 months after starting the second-line chemotherapy. Gemcitabine is the standard regimen for unresectable pancreatic cancer. However, the benefits of second-line chemotherapy remain unclear. S-1 has been reported to show a considerable efficacy, achieving a response rate of 37.5% in chemo-naïve patients with pancreatic cancer. S-1 is therefore considered to be promising as second-line chemotherapy for unresectable pancreatic cancer, due to the fact that a considerable survival benefit has been observed for patients with unresectable pancreatic cancer.
authors.affiliation: Department of Surgery, Saiseikai Yokohamashi Tobu Hospital.
authors.forename: Tomohisa
authors.initials: T
authors.lastname: Egawa
authors.forename: Masaki
authors.initials: M
authors.lastname: Ohashi
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Ito
authors.forename: Koki
authors.initials: K
authors.lastname: Mihara
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Takahashi
authors.forename: Shinobu
authors.initials: S
authors.lastname: Hayashi
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nagashima
mesh_terms: D000284:Administration, Oral; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D004338:Drug Combinations; D006801:Humans; D008297:Male; D008875:Middle Aged; D010094:Oxonic Acid / Q000008:administration & dosage / Q000627:therapeutic use*; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000473:pathology; D010534:Peritoneal Neoplasms / Q000556:secondary; D005641:Tegafur / Q000008:administration & dosage / Q000627:therapeutic use*; D000093542:Gemcitabine
chemical_list: D000964:Antimetabolites, Antineoplastic; D004338:Drug Combinations; D003841:Deoxycytidine; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D000093542:Gemcitabine