BACKGROUND: The most frequent recurrence pattern of advanced gastric cancer is peritoneal dissemination. We investigated the safety of and compliance with sequential chemotherapy consisting of paclitaxel and S-1, both of which are effective in the treatment of peritoneal dissemination. METHODS: The patients in the study all had histologically proven gastric cancer, classified according to the TNM and the Japanese criteria for gastric cancer as T3-4, N0-2, P0, H0 M0, and CY0-1. In all patients, standard gastrectomy of more than a D2 dissection was performed. A dose of 80 mg/m2 of paclitaxel was administered for three courses. One course comprised weekly administration for 3 weeks, followed by a 1-week rest, except for the first course (following S-1 administration at 80 mg/m2 body surface area), in which paclitaxel was administered for only 2 weeks, followed by a 1-week rest. S-1 was administered from day 78 for four courses, with one course comprising 2 weeks' administration followed by a 1-week rest. Fifty patients received paclitaxel chemotherapy. The median age was 62.5 years overall; among the 34 male patients it was 65.5 years, and among the female patients it was 48.0 years. RESULTS: The patient compliance rate was 84%. There were no cases of grade 4 hematological toxicity during either paclitaxel or S-1 treatment. With respect to nonhematological toxicities, there was one case of grade 3 neuropathy during the course of paclitaxel treatment and one case of grade 3 diarrhea during the course of S-1 treatment. These patients recovered and completed the scheduled treatment regimen. CONCLUSION: Sequential chemotherapy of paclitaxel and S-1 as postoperative adjuvant chemotherapy for advanced gastric cancer is feasible.
BACKGROUND: The most frequent recurrence pattern of advanced gastric cancer is peritoneal dissemination. We investigated the safety of and compliance with sequential chemotherapy consisting of paclitaxel and S-1, both of which are effective in the treatment of peritoneal dissemination. METHODS: The patients in the study all had histologically proven gastric cancer, classified according to the TNM and the Japanese criteria for gastric cancer as T3-4, N0-2, P0, H0 M0, and CY0-1. In all patients, standard gastrectomy of more than a D2 dissection was performed. A dose of 80 mg/m2 of paclitaxel was administered for three courses. One course comprised weekly administration for 3 weeks, followed by a 1-week rest, except for the first course (following S-1 administration at 80 mg/m2 body surface area), in which paclitaxel was administered for only 2 weeks, followed by a 1-week rest. S-1 was administered from day 78 for four courses, with one course comprising 2 weeks' administration followed by a 1-week rest. Fifty patients received paclitaxel chemotherapy. The median age was 62.5 years overall; among the 34 male patients it was 65.5 years, and among the female patients it was 48.0 years. RESULTS: The patient compliance rate was 84%. There were no cases of grade 4 hematological toxicity during either paclitaxel or S-1 treatment. With respect to nonhematological toxicities, there was one case of grade 3 neuropathy during the course of paclitaxel treatment and one case of grade 3 diarrhea during the course of S-1 treatment. These patients recovered and completed the scheduled treatment regimen. CONCLUSION: Sequential chemotherapy of paclitaxel and S-1 as postoperative adjuvant chemotherapy for advanced gastric cancer is feasible.
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Authors: Christoph A Klein; Thomas J F Blankenstein; Oleg Schmidt-Kittler; Marco Petronio; Bernhard Polzer; Nikolas H Stoecklein; Gert Riethmüller Journal: Lancet Date: 2002-08-31 Impact factor: 79.321
Authors: Y Yonemura; T Fujimura; G Nishimura; T Sawa; K Katayama; K Tsugawa; S Fushida; I Miyazaki; M Tanaka; Y Endou; T Sasaki Journal: Surgery Date: 1996-04 Impact factor: 3.982
Authors: I Craig Henderson; Donald A Berry; George D Demetri; Constance T Cirrincione; Lori J Goldstein; Silvana Martino; James N Ingle; M Robert Cooper; Daniel F Hayes; Katherine H Tkaczuk; Gini Fleming; James F Holland; David B Duggan; John T Carpenter; Emil Frei; Richard L Schilsky; William C Wood; Hyman B Muss; Larry Norton Journal: J Clin Oncol Date: 2003-03-15 Impact factor: 44.544