Three-weekly s-1 monotherapy as first-line treatment in elderly patients with recurrent or metastatic gastric cancer.
OBJECTIVE
Elderly patients with advanced gastric cancer (AGC) have generally been excluded from clinical trials, and there are few data available on the treatment of these patients. The efficacy of palliative S-1 monotherapy as a first-line treatment regimen for elderly patients has not been well elucidated.


METHODS
For this study, 25 AGC patients were enrolled between January 1, 2007 and March 31, 2009; 4 cases were recurrent AGC and 21 cases were metastatic AGC at the time of diagnosis. These patients received S-1 therapy at a dose of 40 mg/m(2) twice daily for 14 days every 3 weeks. All of the patients were older than 70 years.


RESULTS
The median follow-up duration, the median progression-free survival, and the overall survival time were 8.7 months (range, 4.9 to 12.5 months), 4.9 months (range, 3.5 to 6.3 months), and 10.8 months (range, 6.6 to 15.0 months), respectively. Grade 3/4 nonhematologic toxicities were rare. Grade 3/4 neutropenia was noted in two patients. The partial response rate was 21.7% and stable disease was observed in 34.8% of the patients. Two patients (8%) died due to chemotherapy-associated toxicity during treatment (septic shock/intracranial hemorrhage).


CONCLUSIONS
Oral S-1 chemotherapy seems to be effective as a first-line treatment regimen for elderly patients with metastatic or recurrent AGC. However, elderly patients receiving S-1 treatment should undergo continuous toxicity monitoring, since they are highly susceptible to adverse effects.
Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, Korea.
Joo Han
JH
Lim
Moon Hee
MH
Lee
Hyung Gil
HG
Kim
Yong Woon
YW
Shin
Hyeon Gyu
HG
Yi
Seok Hwan
SH
Shin
Yoon Seok
YS
Hur
Chul Soo
CS
Kim
Hye Jeong
HJ
Chang
J Clin Epidemiol. 2003 Jan;56(1):1-9
12589864
Br J Cancer. 2008 Aug 19;99(4):584-90
18665164
Crit Rev Oncol Hematol. 2008 Apr;66(1):84-90
18243012
Cancer Chemother Pharmacol. 2008 Apr;61(5):837-45
17579864
Gastric Cancer. 2003;6 Suppl 1:34-9
12775018
Cancer Res. 1993 Sep 1;53(17):4004-9
7689420
Gastric Cancer. 2002;5(3):177-82
12378346
Oncology. 2000 Apr;58(3):191-7
10765119
Ann Oncol. 1997 Feb;8(2):163-8
9093725
Am J Clin Oncol. 2008 Jun;31(3):259-63
18525305
Eur J Cancer. 1998 Oct;34(11):1715-20
9893658
Cancer Res Treat. 2007 Sep;39(3):99-103
19746224
ANZ J Surg. 2006 Jun;76(6):458-61
16768768
Support Cancer Ther. 2005 Jul 1;2(4):225-8
18628177