Department of Gastroenterology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
Int J Clin Oncol. 2017 Dec;22(6):1060-1068. doi: 10.1007/s10147-017-1164-4. Epub 2017 Jul 26.
Peritoneal cytology positive for carcinoma cells (CY+) is an independent poor prognostic factor in gastric cancer, and patients with CY+ are diagnosed with stage IV disease. However, there is no standard treatment strategy for CY+ gastric cancer, whereas combination chemotherapy with fluoropyrimidine and platinum has been established as the standard treatment for unresectable advanced gastric cancer or after R2 resection. Herein, we assessed whether adding cisplatin to S-1 (SP) could improve the outcome of CY+ gastric cancer patients, as compared to S-1 monotherapy.
This retrospective study was conducted at a single Japanese institute between June 2005 and March 2014. Patients diagnosed with CY+ advanced gastric cancer and treated with S-1-based therapy were enrolled. Patients with incurable factors other than CY+ were excluded.
Forty-four patients were enrolled; 25 and 19 were administered S-1 and SP, respectively. The 2-year survival rates were 52.0% [95% confidence interval (CI), 31.2-69.2%] and 52.6% (28.7-71.9%) in the S-1 and SP groups, respectively. The median overall survival (OS) and progression-free survival (PFS) were 28.2 and 15.6 months in the S-1 group and 24.0 and 18.8 months in the SP group, respectively; they were not significantly different. The relative dose intensities were 0.79 (S-1) in the S-1 group and 0.69 (S-1)/0.70 (cisplatin) in the SP group.
Adding cisplatin to long-term S-1 monotherapy did not significantly improve the outcome of CY+ advanced gastric cancer patients.
腹膜细胞学检查阳性的癌细胞（CY+）是胃癌的独立不良预后因素，CY+患者被诊断为 IV 期疾病。然而，对于 CY+胃癌尚无标准的治疗策略，而氟嘧啶联合铂类药物的联合化疗已被确立为不可切除的晚期胃癌或 R2 切除后的标准治疗方法。在此，我们评估了与 S-1 单药治疗相比，向 S-1（SP）中添加顺铂是否可以改善 CY+胃癌患者的结局。
这是一项在日本的单机构进行的回顾性研究，时间为 2005 年 6 月至 2014 年 3 月。入组接受 S-1 为基础的治疗的被诊断为 CY+晚期胃癌的患者。排除除 CY+以外无不可治愈因素的患者。
入组了 44 例患者；25 例和 19 例患者分别接受了 S-1 和 SP 治疗。S-1 组和 SP 组的 2 年生存率分别为 52.0%（95%置信区间，31.2-69.2%）和 52.6%（28.7-71.9%）。S-1 组的中位总生存期（OS）和无进展生存期（PFS）分别为 28.2 个月和 15.6 个月，SP 组分别为 24.0 个月和 18.8 个月；两组之间无显著差异。S-1 组的相对剂量强度为 0.79（S-1），SP 组为 0.69（S-1）/0.70（顺铂）。
向长期 S-1 单药治疗中添加顺铂并未显著改善 CY+晚期胃癌患者的结局。
