title: Second-line chemotherapy with paclitaxel and doxifluridine after failure of S-1 in elderly patients with unresectable advanced or recurrent gastric cancer.
abstract: OBJECTIVE
  There is no standard second-line treatment for patients with unresectable advanced or recurrent gastric cancer (URGC) in the event that first-line treatment fails. Moreover, the benefits of second-line chemotherapy in elderly patients remain uncertain. The aim of this study was to identify the benefits of the second-line paclitaxel (PTX) plus doxifluridine (5'-DFUR) regimen for URGC in elderly patients in comparison to nonelderly patients.
  
  
  METHODS
  We retrospectively examined the clinical outcomes of the second-line PTX plus 5'-DFUR regimen in patients with URGC, who had previously been treated with S-1-based first-line chemotherapy.
  
  
  RESULTS
  A total of 27 patients (10 elderly, ≥70 years old; 17 nonelderly, <70 years old) were enrolled in the study. The clinical benefit rate (complete response, partial response, and stable disease) in the elderly group was 6 of 10 (60%), and that of the nonelderly group was 9 of 17 (53%). Age had no statistically significant influence on the response rate, and no grade 4 adverse events were observed in either group. In addition, the median survival time was 12.2 months in both groups.
  
  
  CONCLUSIONS
  Although it remains unclear whether second-line chemotherapy contributes to survival in patients with URGC, the combination of PTX plus 5'-DFUR might be the treatment of choice for second-line chemotherapy in both elderly and nonelderly patients who have already received an S-1-based first-line treatment.
authors.affiliation: Department of Surgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan. kashiwad@cc.saga-u.ac.jp
authors.forename: Tomomi
authors.initials: T
authors.lastname: Yakabe
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Noshiro
authors.forename: Osamu
authors.initials: O
authors.lastname: Ikeda
authors.forename: Atsushi
authors.initials: A
authors.lastname: Miyoshi
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Kitajima
authors.forename: Seiji
authors.initials: S
authors.lastname: Satoh
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D004338:Drug Combinations; D005260:Female; D005467:Floxuridine / Q000008:administration & dosage; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D010094:Oxonic Acid / Q000627:therapeutic use*; D017239:Paclitaxel / Q000008:administration & dosage; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000401:mortality; D005641:Tegafur / Q000627:therapeutic use*
chemical_list: D004338:Drug Combinations; D005467:Floxuridine; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D017239:Paclitaxel; C025034:doxifluridine