[Tolerable evaluation for chemotherapy with S-1 plus cisplatin in elderly patients with advanced and recurrent gastric cancer].
This retrospective study examined the extent to which S-1 plus cisplatin is applicable to the elderly as a primary therapy for advanced or recurrent gastric cancer. Subjects under age 70 were categorized as the L group(n=42), and those age 70 and over were categorized as the O group(n=18). The 2 groups were compared in terms of their creatinine clearance(Ccr), performance status(PS), dose intensity(DI), reasons for regimen modification or discontinuation, and adverse reactions. The DI of S-1 was 100(50-100)% in the L group and 83(67-100)% in the H group(p<0. 0001), and the DI of cisplatin was 100(70-100)% in the L group and 87(75-100)% in the H group(p<0. 0001). The incidence of adverse reactions was similar for both groups. However, the S-1 plus cisplatin regimen was discontinued either at the patient's request, or based on the physician's determination that there were adverse reactions such as fatigue or anorexia. There were significantly more of these reactions in the H group(72. 2%)in comparison to the L group(42. 9%)(p=0. 0369). The elderly often had complications, and a decrease in PS as a result of repeatedly undergoing chemotherapy was noted(p=0. 0185). In conclusion, the elderly may have a low tolerance to S-1 plus cisplatin. When administering cancer chemotherapy to the elderly aged 70 and older, the patient's renal function, PS and Ccr, should be studied, and a regimen and dosage should be carefully selected.
Dept. of Pharmacy, Ogaki Municipal Hospital, Japan.
Michio
M
Kimura
Eiseki
E
Usami
Daisuke
D
Ito
Mina
M
Iwai
Kazutomo
K
Okada
Toshiya
T
Nakao
Tomoaki
T
Yoshimura
Tadashi
T
Yasuda
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D003401:Creatine / Q000097:blood; D004338:Drug Combinations; D004361:Drug Tolerance; D005260:Female; D006801:Humans; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010094:Oxonic Acid / Q000008:administration & dosage / Q000009:adverse effects; D012008:Recurrence; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000473:pathology; D005641:Tegafur / Q000008:administration & dosage / Q000009:adverse effects
D004338:Drug Combinations; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D003401:Creatine; D002945:Cisplatin