Department of Medical Oncology Center, Tonan Hospital, Chuo-ku, Sapporo, Japan.
Jpn J Clin Oncol. 2010 Apr;40(4):302-6. doi: 10.1093/jjco/hyp177. Epub 2010 Jan 19.
Although combination chemotherapy with 3 weeks of S-1 and cisplatin is effective for advanced gastric cancer, the toxicities of S-1 which mostly occur during the third week of administration are a major problem. To achieve fewer adverse effects with S-1 and higher dose intensity of cisplatin, we performed combination chemotherapy with 2 weeks of S-1 and cisplatin as first line. The aim of this retrospective study was to analyse the efficacy and feasibility of this regimen.
S-1 (40-60 mg depending on patient's body surface area) was given orally twice daily for 2 consecutive weeks, and 70 mg/m(2) cisplatin was given intravenously on day 8, followed by a 2-week rest period.
Forty-eight patients received a total of 184 courses of chemotherapy. Overall response rate was 40.6% and median survival time was 411 days. Dose intensities were 257.6 mg/m(2)/week for S-1 and 16.4 mg/m(2)/week for cisplatin. The incidences of grade 3/4 haematological toxicities were leucopenia (19%), neutropenia (29%) and anaemia (17%), and those of grade 3 non-haematological toxicities were anorexia (31%) and nausea (21%). The rate of treatment discontinuation owing to toxicity was 10%.
This regimen may be effective as an alternative therapy to 3 weeks of S-1 and cisplatin to reduce the toxicity of chemotherapy for advanced gastric cancer.
虽然 S-1 和顺铂联合化疗 3 周治疗晚期胃癌具有疗效，但 S-1 的毒性主要发生在第 3 周，这是一个主要问题。为了减少 S-1 的不良反应并提高顺铂的剂量强度，我们采用 2 周 S-1 和顺铂联合化疗作为一线治疗。本回顾性研究的目的是分析该方案的疗效和可行性。
S-1（根据患者体表面积为 40-60mg）口服，每日 2 次，连续 2 周，第 8 天给予 70mg/m2顺铂静脉滴注，随后休息 2 周。
48 例患者共接受了 184 个疗程的化疗。总缓解率为 40.6%，中位生存时间为 411 天。S-1 的剂量强度为 257.6mg/m2/周，顺铂的剂量强度为 16.4mg/m2/周。3/4 级血液学毒性的发生率为白细胞减少（19%）、中性粒细胞减少（29%）和贫血（17%），3/4 级非血液学毒性的发生率为食欲不振（31%）和恶心（21%）。因毒性而停止治疗的比例为 10%。
该方案可能是替代 S-1 和顺铂治疗晚期胃癌的 3 周化疗的有效方法，可以减少化疗的毒性。
