Fujitani Kazumasa, Tsujinaka Toshimasa, Hirao Motohiro
Department of Surgery, Osaka National Hospital, 2-1-14, Hoenzaka, Chuo-ku, Osaka 540-0006, Japan.
Hepatogastroenterology. 2003 May-Jun;50(51):889-92.
BACKGROUND/AIMS: Despite improvements in chemotherapy and surgical techniques, the prognosis in advanced gastric cancer with peritoneal dissemination still remains very poor. At present, no standard method of treatment has been established for these patients. Therefore, we assessed the feasibility of S-1, a novel oral derivative of 5-fluorouracil, as a postoperative adjuvant chemotherapy for these patients.
Seven patients were enrolled for 1 year. All patients underwent macroscopically curative resection (R1) by an aggressive cytoreductive surgery. S-1 was given orally at a dose of 80 mg/m2/day, for 28 consecutive days followed by a 14-day rest, repeated every 6 weeks.
S-1 was administered for 1 year in 3 out of 7 patients, while the treatment was discontinued in 4 patients due to disease progression. The median S-1 1 cycle given was 5. Grade 2 leukopenia was observed in 3 patients and grade 2 elevation of total bilirubin in one patient. All other adverse reactions were grade 1. The median overall survival was > 696 days with a 1-year survival rate of 85.7%. The median overall progression-free survival was 213 days.
S-1 is feasible as a postoperative adjuvant chemotherapy for resectable gastric cancer with peritoneal seeding.
背景/目的：尽管化疗和手术技术有所改进，但晚期胃癌伴腹膜播散患者的预后仍然很差。目前，尚未为这些患者建立标准的治疗方法。因此，我们评估了新型口服5-氟尿嘧啶衍生物S-1作为这些患者术后辅助化疗的可行性。
7例患者入组，治疗1年。所有患者均通过积极的细胞减灭术进行了肉眼下根治性切除（R1）。S-1以80mg/m²/天的剂量口服，连续服用28天，随后休息14天，每6周重复一次。
7例患者中有3例接受S-1治疗1年，4例患者因疾病进展而停止治疗。给予S-1的中位周期数为5个。3例患者出现2级白细胞减少，1例患者出现2级总胆红素升高。所有其他不良反应均为1级。中位总生存期>696天，1年生存率为85.7%。中位无进展生存期为213天。
S-1作为可切除胃癌伴腹膜种植术后辅助化疗是可行的。
