Gastrointestinal Medical Oncology Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
J Cancer Res Clin Oncol. 2013 Dec;139(12):2111-6. doi: 10.1007/s00432-013-1537-7. Epub 2013 Oct 16.
We retrospectively examined the efficacy and safety of S-1 alone or S-1 plus cisplatin (SP) for elderly patients with advanced gastric cancer because the benefit of adding cisplatin in these patients still remains unclear.
Among 175 patients aged 70 years or older who received S-1 alone or SP as a first-line therapy between April 2000 and November 2010 at our institution, 104 patients who met eligibility criteria were examined. We investigated safety and efficacy of S-1 and SP.
Among these 104 patients, 73 patients received S-1 and 31 patients received SP. The median age was 75 years in the S-1 group and 74 years in the SP group. The response rate was 26.3 % in the S-1 group and 44.0 % in the SP group. Major grade 3 or higher adverse events were observed as follows (S-1 vs. SP): nausea (1.4 vs. 16.1 %), anorexia (16.4 vs. 41.9 %), neutropenia (4.1 vs. 35.5 %), and febrile neutropenia (0 vs. 9.7 %). The median overall survival (OS) was 10.4 months in the S-1 group and 17.8 months in the SP group. Treatment of SP and histology of intestinal type were detected as independent, good prognostic factors in multivariate analysis.
SP might improve OS with some added toxicity compared to S-1 alone in elderly patients with advanced gastric cancer.
我们回顾性地研究了 S-1 单药或 S-1 联合顺铂（SP）治疗老年晚期胃癌患者的疗效和安全性，因为在这些患者中添加顺铂的获益仍不清楚。
在我们机构，2000 年 4 月至 2010 年 11 月期间，175 例年龄 70 岁或以上的患者接受了 S-1 单药或 SP 作为一线治疗，其中符合入选标准的 104 例患者接受了检查。我们调查了 S-1 和 SP 的安全性和疗效。
在这 104 例患者中，73 例患者接受了 S-1 治疗，31 例患者接受了 SP 治疗。S-1 组的中位年龄为 75 岁，SP 组的中位年龄为 74 岁。S-1 组的缓解率为 26.3%，SP 组为 44.0%。主要的 3 级或以上不良事件如下（S-1 与 SP 相比）：恶心（1.4%与 16.1%）、食欲不振（16.4%与 41.9%）、中性粒细胞减少症（4.1%与 35.5%）和发热性中性粒细胞减少症（0%与 9.7%）。S-1 组的中位总生存期（OS）为 10.4 个月，SP 组为 17.8 个月。多因素分析显示，SP 治疗和肠型组织学是独立的预后良好因素。
与 S-1 单药相比，SP 可能改善老年晚期胃癌患者的 OS，但毒性也有所增加。
