Wada Keita, Sano Keiji, Amano Hodaka, Miura Fumihiko, Toyota Naoyuki, Ito Hiromichi, Shibuya Makoto, Ikeda Yutaka, Kainuma Masahiko, Takada Tadahiro
Department of Surgery, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605, Japan.
J Hepatobiliary Pancreat Sci. 2015 Sep;22(9):692-8. doi: 10.1002/jhbp.274. Epub 2015 Jul 1.
Chemotherapy for unresectable pancreatic cancer should not only prolong survival but maintain quality of life, considering its limited life expectancy. To achieve these goals, biweekly gemcitabine plus S-1 was assessed in the clinical practice setting.
Fifty-two patients with either locally advanced or metastatic pancreatic cancer who received biweekly gemcitabine plus S-1 as a first-line anti-cancer treatment were included in this study. Treatment delivery, toxicity, response, and survival were reviewed to assess the feasibility and efficacy.
The completion rate of treatment delivery was 95.1%, with relative dose intensity of 97.1% for gemcitabine and 97.3% for S-1. Overall, grade 3 or worse adverse events were rare, with hematologic toxicities occurring in 5.8%. The objective response rate was 30.8%, and more than a 50% reduction of CA19-9 was observed in 77.1%. Surgical conversion was completed with a margin-negative resection in four patients whose tumor had shrunk for at least 6 months. The median progression-free and overall survivals were 10.4 and 18.2 months, respectively. Reduction of CA19-9 was associated with longer survival.
Biweekly gemcitabine plus S-1 may be a good alternative to current standard chemotherapies for unresectable pancreatic cancer with less toxicity and less treatment burden without losing efficacy.
鉴于不可切除胰腺癌患者预期寿命有限，其化疗不仅应延长生存期，还应维持生活质量。为实现这些目标，在临床实践中对每两周一次的吉西他滨联合S-1方案进行了评估。
本研究纳入了52例局部晚期或转移性胰腺癌患者，他们接受每两周一次的吉西他滨联合S-1作为一线抗癌治疗。对治疗实施情况、毒性、反应和生存情况进行了回顾，以评估其可行性和疗效。
治疗实施完成率为95.1%，吉西他滨的相对剂量强度为97.1%，S-1为97.3%。总体而言，3级或更严重的不良事件很少见，血液学毒性发生率为5.8%。客观缓解率为30.8%，77.1%的患者CA19-9降低超过50%。4例肿瘤缩小至少6个月的患者完成了手术转化并进行了切缘阴性的切除。无进展生存期和总生存期的中位数分别为10.4个月和18.2个月。CA19-9降低与更长的生存期相关。
对于不可切除的胰腺癌，每两周一次的吉西他滨联合S-1可能是当前标准化疗的一个良好替代方案，毒性更小，治疗负担更轻，且不影响疗效。
