Ako Eiji, Ohira Masaichi, Yamashita Yoshito, Kubo Naoshi, Muguruma Kazuya, Yashiro Masakazu, Sawada Tetsuji, Nakata Bunzo, Kato Yasuyuki, Hirakawa Kosei
Department of Surgical Oncology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan.
Hepatogastroenterology. 2008 Sep-Oct;55(86-87):1939-42.
BACKGROUND/AIMS: Positive peritoneal lavage cytology (PLC) is a strong predictor of subsequent frank peritoneal dissemination. The prognosis for patients with positive PLC is as poor as with macroscopic peritoneal dissemination. We examined the clinical efficacy of S-1 chemotherapy against gastric cancer with positive PLC after macroscopically curative resection.
Among our gastric cancer patients proving to have positive PLC after operation, 17 treated between 2000 and 2005 and 20 treated between 1986 and 1999 respectively represented S-1 and non-S-1 groups, between which we compared survival rates. S-1 was administered orally twice daily at a dose of 80 mg/m2/day for 28 consecutive days followed by a 14-day pause, thus repeating the cycle every 6 weeks.
S-1 was administered for more than 2 cycles in all patients (median, 10 cycles). Grade 3 adverse reactions to S-1 occurred in two patients. Other adverse reactions were grade 2 or less. Cumulative survival in the S-1 group was better than in the non-S-1 group (p=0.0034), with 1- and 3-year survival rates of 87.5% and 71.6% vs. 59.0% and 17.1%.
S-1 is effective as postoperative chemotherapy for gastric cancer patients with positive PLC after macroscopically curative resection.
背景/目的：阳性腹腔灌洗细胞学检查（PLC）是后续明显腹膜播散的有力预测指标。PLC阳性患者的预后与肉眼可见的腹膜播散患者一样差。我们研究了S-1化疗对宏观上根治性切除术后PLC阳性胃癌患者的临床疗效。
在我们术后PLC阳性的胃癌患者中，2000年至2005年期间接受治疗的17例患者和1986年至1999年期间接受治疗的20例患者分别代表S-1组和非S-1组，我们比较了两组的生存率。S-1口服给药，每日两次，剂量为80mg/m²/天，连续服用28天，然后停药14天，每6周重复一个周期。
所有患者S-1治疗均超过2个周期（中位数为10个周期）。两名患者出现3级S-1不良反应。其他不良反应为2级或以下。S-1组的累积生存率优于非S-1组（p=0.0034），1年和3年生存率分别为87.5%和71.6%，而非S-1组分别为59.0%和17.1%。
对于宏观上根治性切除术后PLC阳性的胃癌患者，S-1作为术后化疗有效。
