Safety and feasibility of adjuvant chemotherapy with S-1 for Korean patients with curatively resected advanced gastric cancer.

Abstract

BACKGROUND:

Adjuvant chemotherapy with S-1 was proven to be effective in Japanese patients with advanced gastric cancer curatively resected with D2 lymph node dissection.

MATERIALS AND METHODS:

We retrospectively evaluated the medical records of 305 patients with stage II, III or IV (M0) gastric cancer who had received adjuvant S-1 chemotherapy following curative gastrectomy with D2 lymph node dissection between October 2007 and December 2009. Adjuvant S-1 was administered at a dose of 40 mg/m(2) twice daily for 4 weeks followed by 2 weeks of rest, every 6 weeks for eight cycles.

RESULTS:

Of the 305 patients, 248 (81.3 %) and 198 (64.9 %) completed four and eight cycles of adjuvant chemotherapy, respectively. The most common reasons for discontinuing treatment prior to the planned eight cycles were adverse events (n = 47, 15.4 %) and tumor recurrence (n = 28, 9.2 %). Sixty-five (21.3 %) patients required dose reduction due to adverse events. The most common grade 3/4 toxicities were neutropenia (n = 39, 12.8 %), diarrhea (n = 15, 4.9 %). Multivariate analysis showed that total gastrectomy [odds ratio (OR) 2.44; 95 % confidence interval (CI) 1.29-4.62, p = 0.006] was an independent risk factor for grade 3/4 hematologic toxicities, and age > 65 years (OR 2.60; 95 % CI 1.34-5.07, p = 0.005) was an independent risk factor for grade 3 non-hematologic toxicities.

CONCLUSIONS:

Adjuvant chemotherapy with S-1 for 1 year is safe and feasible in Korean patients. Age > 65 years and total gastrectomy are independent risk factors for severe adverse events caused by adjuvant S-1 chemotherapy.

• Authors: Jae Ho Jeong, Min-Hee Ryu, Baek-Yeol Ryoo, Sung Sook Lee, Inkeun Park, Sang Hong Lee, Kab Choong Kim, Jeong Hwan Yook, Sung Tae Oh, Byung Sik Kim, Yoon-Koo Kang
• Journal: Cancer chemotherapy and pharmacology (Cancer Chemother Pharmacol) Vol. 70 Issue 4 Pg. 523-9 (Oct 2012) ISSN: 1432-0843 [Electronic] Germany
• PMID: 22864947 (Publication Type: Journal Article)

Chemical References

• Antimetabolites, Antineoplastic
• Drug Combinations
• S 1 (combination)
• Tegafur
• Oxonic Acid

Topics

• Adult
• Aged
• Aged, 80 and over
• Antimetabolites, Antineoplastic (adverse effects)
• Chemotherapy, Adjuvant (adverse effects)
• Drug Combinations
• Female
• Gastrectomy
• Humans
• Logistic Models
• Male
• Middle Aged
• Oxonic Acid (adverse effects)
• Retrospective Studies
• Stomach Neoplasms (drug therapy, mortality)
• Tegafur (adverse effects)