title: Tolerability of adjuvant chemotherapy with S-1 after curative resection in patients with stage II/III gastric cancer.
abstract: The results of the Japan Clinical Oncology Group trial demonstrated that adjuvant chemotherapy with S-1 for stage II/III gastric cancer is effective and suggested that this therapy should be adopted as the standard treatment following curative D2 gastric dissection. We reviewed treatment outcomes in 58 consecutive patients who received adjuvant therapy with S-1 for stage II/III gastric cancer following curative D2 dissection; the standard dosage used was determined on the basis of the patient body surface area. Twenty-four patients (41.3%) discontinued treatment before 12 months. Patients who completed 12 months of adjuvant therapy with S-1 were younger and more frequently treated by senior doctors (>15 years of experience) than those who did not. However, no differences existed in pathological features and surgical procedures between groups. Overall survival and relapse-free survival were better in patients who completed 12 months of adjuvant therapy with S-1. Fatigue and nausea were associated with discontinuation of S-1 treatment. In conclusion, immediately after surgery, fatigue and gastrointestinal symptoms of ≤ grade 2 may have a major impact on treatment compliance. Prior to the commencement of S-1 administration, both patients and doctors should be made completely aware of the toxicity, compliance and efficacy issues associated with this adjuvant therapy.
authors.affiliation: Department of Surgery, National Defense Medical College, Tokorozawa 359-8513,  Japan.
authors.forename: Hironori
authors.initials: H
authors.lastname: Tsujimoto
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Horiguchi
authors.forename: Shuichi
authors.initials: S
authors.lastname: Hiraki
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Yaguchi
authors.forename: Risa
authors.initials: R
authors.lastname: Takahata
authors.forename: Isao
authors.initials: I
authors.lastname: Kumano
authors.forename: Kazumichi
authors.initials: K
authors.lastname: Yoshida
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Matsumoto
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ono
authors.forename: Junji
authors.initials: J
authors.lastname: Yamamoto
authors.forename: Kazuo
authors.initials: K
authors.lastname: Hase