Department of Surgery, Jichi Medical University, 3311-1 Shimotsuke, Tochigi, 329-0498, Japan.
Int J Clin Oncol. 2010 Apr;15(2):166-71. doi: 10.1007/s10147-010-0036-y. Epub 2010 Mar 2.
In patients with adverse events of S-1, the dose is generally reduced or the treatment cycle is shortened. Whether the therapeutic effectiveness of modified regimens is similar to that of the standard dosage remains unclear.
We retrospectively studied patients with gastric cancer who received S-1 on alternate days.
A total of 266 patients received S-1 on alternate days. In 116 patients, S-1 was initially given at the standard dosage but was switched to alternate-day treatment because of toxicity within 28 days on average. The other 150 patients initially received alternate-day treatment because of poor general condition. In the adjuvant chemotherapy group (n = 96), the 3-year survival rate was 88% in patients with stage II, 73% in stage IIIA, and 67% in stage IIIB who underwent D2 lymph-node dissection. In the palliative surgery group (n = 96), the response rate was 13%, with a median survival time (MST) of 624 days. In patients with unresectable/recurrent disease (n = 74), the response rate was 25%, with an MST of 338 days. Among the 116 patients who initially received treatment on consecutive days, 100% had grade 1, 53% had grade 2, and 5.2% had grade 3 adverse events. When S-1 was switched to alternate-day treatment, toxicity decreased in all patients. In the 266 patients who received alternate-day treatment, 8% had grade 1, 6% had grade 2, and 0% had grade 3 adverse events.
Alternate-day treatment with S-1 may have milder adverse events without compromising therapeutic effectiveness.
在出现替吉奥不良反应的患者中，一般会减少剂量或缩短治疗周期。但改变方案后的治疗效果是否与标准剂量相当仍不明确。
我们回顾性分析了接受替吉奥隔日治疗的胃癌患者。
共有 266 例患者接受了替吉奥隔日治疗。其中 116 例患者在 28 天内因毒性作用平均开始使用标准剂量替吉奥，但改为隔日治疗；另外 150 例患者因一般情况较差，初始就接受隔日治疗。辅助化疗组（n = 96）中，接受 D2 淋巴结清扫的Ⅱ期、ⅢA 期和ⅢB 期患者的 3 年生存率分别为 88%、73%和 67%。姑息手术组（n = 96）的缓解率为 13%，中位生存时间（MST）为 624 天。在不可切除/复发性疾病患者（n = 74）中，缓解率为 25%，MST 为 338 天。在初始连续治疗的 116 例患者中，100%出现 1 级毒性，53%出现 2 级毒性，5.2%出现 3 级毒性。当替吉奥改为隔日治疗时，所有患者的毒性均减轻。在接受隔日治疗的 266 例患者中，8%出现 1 级毒性，6%出现 2 级毒性，0%出现 3 级毒性。
替吉奥隔日治疗的不良反应可能较轻，而不会影响治疗效果。
