Impact of adding cisplatin to S-1 in elderly patients with advanced gastric cancer

• Published in: Journal of cancer research and clinical oncology 2013-12, Vol.139 (12), p.2111-2116
• Main Authors: Terazawa, Tetsuji, Iwasa, Satoru, Takashima, Atsuo, Nishitani, Hitoshi, Honma, Yoshitaka, Kato, Ken, Hamaguchi, Tetsuya, Yamada, Yasuhide, Shimada, Yasuhiro
• Format: Article
• Language: English
• Subjects: Adenocarcinoma - drug therapy; Adenocarcinoma - mortality; Adenocarcinoma - pathology; Aged; Aged, 80 and over; Antineoplastic agents; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Cancer Research; Chemotherapy; Cisplatin - administration & dosage; Cisplatin - adverse effects; Disease Progression; Drug Combinations; Female; Gastric cancer; Gastroenterology. Liver. Pancreas. Abdomen; Hematology; Humans; Internal Medicine; Male; Medical sciences; Medicine; Medicine & Public Health; Multiple tumors. Solid tumors. Tumors in childhood (general aspects); Neoadjuvant Therapy; Older people; Oncology; Original Paper; Oxonic Acid - administration & dosage; Oxonic Acid - adverse effects; Pharmacology. Drug treatments; Retrospective Studies; Stomach Neoplasms - drug therapy; Stomach Neoplasms - mortality; Stomach Neoplasms - pathology; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Tegafur - administration & dosage; Tegafur - adverse effects; Treatment Outcome; Tumors
• ISSN: 0171-5216; 1432-1335
• DOI: 10.1007/s00432-013-1537-7

Purpose 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. Patients and methods 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. Results 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. Conclusion SP might improve OS with some added toxicity compared to S-1 alone in elderly patients with advanced gastric cancer.