title: Reduction in gastrointestinal toxicity by gastric secretion inhibitors during S-1 monotherapy for patients with gastric cancer.
abstract: The purpose of this study was to retrospectively examine the effect of concomitant administration of gastric secretion inhibitors or gastrectomy on the frequency of gastrointestinal toxicity caused by 5-fluorouracil (5-FU) in gastric cancer patients receiving chemotherapy with S-1. In 62 gastric cancer patients treated with S-1 alone, data relating to the occurrence of gastrointestinal toxicity (diarrhea, vomiting, and nausea) and possible contributing factors were retrospectively collected, and logistic regression analysis was performed. Time-to-event data relating to the occurrence of gastrointestinal toxicity were also collected, and the effect of gastric secretion inhibitors on the time-to-event profiles was examined using a log-rank test. Logistic regression analysis suggested that the frequency of gastrointestinal toxicity was significantly reduced by the administration of gastric secretion inhibitors (p=0.01; odds ratio, 0.197; 95% confidence interval (CI), 0.056-0.694) and that gastrointestinal toxicity correlated with the estimated glomerular filtration rate (p=0.04; odds ratio, 0.956; 95% CI, 0.916-0.997). The median time-to-event of gastrointestinal toxicity was 85 d for patients that received gastric secretion inhibitors, which was significantly different from the 42 d for patients that did not receive the inhibitors (p=0.02, log-rank test). No clear effect of gastrectomy was found in the present study. The prophylactic use of gastric secretion inhibitors in gastric cancer patients treated with S-1 may decrease and delay the occurrence of gastrointestinal toxicity.
authors.affiliation: Kyoto Pharmaceutical University.
authors.forename: Yugo
authors.initials: Y
authors.lastname: Chisaki
authors.forename: Satoshi
authors.initials: S
authors.lastname: Noda
authors.forename: Daiki
authors.initials: D
authors.lastname: Hira
authors.forename: Shin-Ya
authors.initials: SY
authors.lastname: Morita
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Yano
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Terada
mesh_terms: D000368:Aged; D003967:Diarrhea / Q000139:chemically induced / Q000517:prevention & control; D004305:Dose-Response Relationship, Drug; D004338:Drug Combinations; D005260:Female; D005753:Gastric Mucosa / Q000187:drug effects / Q000378:metabolism; D006635:Histamine H2 Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced / Q000517:prevention & control; D010094:Oxonic Acid / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D054328:Proton Pump Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000601:surgery; D005641:Tegafur / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D014839:Vomiting / Q000139:chemically induced / Q000517:prevention & control
chemical_list: D004338:Drug Combinations; D006635:Histamine H2 Antagonists; D054328:Proton Pump Inhibitors; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid