Department of Pharmacy, Izumi General Medical Center, 520, Myojin-cho, Izumi-shi, Kagoshima 899-0131, Japan.
Cancer Chemother Pharmacol. 2010 Mar;65(4):807-9. doi: 10.1007/s00280-009-1216-1.
The safety and efficacy of S-1 in hemodialysis patients have not been established. We evaluated the safety and efficacy and pharmacokinetics of S-1 in a hemodialysis patient with advanced gastric cancer.
A 66-year-old Japanese man with chronic renal failure, who had undergone hemodialysis three times a week for 3 years. Based on the diagnosis of stage IV gastric cancer, S-1 therapy was started. S-1 was administered 11 times at a daily dose of 23.5 mg/m(2) (40 mg/body)after hemodialysis, followed by a rest. One course was a period of 28 days. Blood samples were obtained after the first administration of S-1 and before beginning the fourth course. The concentration of 5-FU was determined by high-performance liquid chromatography.
Area under the concentration-time curve (AUC)of 5-FU was 2647.2 ng h/mL after administration of S-1 of 23.5 mg/m(2) (40 mg/body). During the S-1 treatment,serious adverse events such as neutropenia were not observed; however, decreases in hemoglobin level were observed (grade 3). The treatment was well tolerated. After the second course of chemotherapy, the primary lesion showed a partial response and lymph node metastases and liver metastases showed stable disease.
Our results suggest that S-1 is an important treatment option for patients with hemodialysis with advanced gastric cancer.
S-1 用于血液透析患者的安全性和疗效尚未确定。我们评估了 S-1 在一名晚期胃癌血液透析患者中的安全性、疗效和药代动力学。
一名 66 岁日本男性，患有慢性肾衰竭，已接受每周 3 次的血液透析治疗 3 年。根据 IV 期胃癌的诊断，开始 S-1 治疗。S-1 于血液透析后每天以 23.5mg/m²（40mg/体）的剂量给予 11 次，然后休息。一个疗程为 28 天。在首次给予 S-1 后并在开始第四个疗程前采集血样。通过高效液相色谱法测定 5-FU 的浓度。
给予 23.5mg/m²（40mg/体）的 S-1 后，5-FU 的浓度-时间曲线下面积（AUC）为 2647.2ng h/mL。在 S-1 治疗期间，未观察到严重不良事件，如中性粒细胞减少症；然而，观察到血红蛋白水平下降（3 级）。治疗耐受良好。在第二疗程化疗后，原发病灶显示部分缓解，淋巴结转移和肝转移显示疾病稳定。
我们的结果表明，S-1 是血液透析晚期胃癌患者的重要治疗选择。
