S-1 Monotherapy as a Neoadjuvant Treatment for Locally Advanced Gastric Cancer
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S-1, a novel oral fluoropyrimidine, is an effective therapeutic agent for gastric cancer. Herein, we report a case with locally advanced gastric cancer that achieved a curative resection after S-1 monotherapy as neoadjuvant treatment. A 68-year-old man was diagnosed with gastric cancer and massive lymphadenopathy involving the perigastric, celiac axis and splenic hilum. His clinical stage was cT3N2H0P0M0. Considering his relatively poor performance (ECOG 2, severe weight loss) and advanced age, we started the patient on S-1 monotherapy at a dose of 35 mg/m2 bid for 4 consecutive weeks followed by a 2-week rest. Follow-up study after 4 treatment cycles revealed disappearance of the lymphadenopathy of the perigastric and celiac axis with diminished extension of the stomach mass. The patient had a partial response (PR) with a 72% tumor reduction, according to the Response Evaluation Criteria in Solid Tumors (RECIST). His performance status was improved to an ECOG 1 and he gained 7 kg. A curative (R0) resection was achieved with a radical total gastrectomy and D2 dissection. The pathological stage was pT3N2M0, stage IIIB. In conclusion, S-1 neoadjuvant chemotherapy aided in the treatment of gastric cancer in this patient.
Abstract
S-1, a novel oral fluoropyrimidine, is an effective therapeutic agent for gastric cancer. Herein, we report a case with locally advanced gastric cancer that achieved a curative resection after S-1 monotherapy as neoadjuvant treatment. A 68-year-old man was diagnosed with gastric cancer and massive lymphadenopathy involving the perigastric, celiac axis and splenic hilum. His clinical stage was cT3N2H0P0M0. Considering his relatively poor performance (ECOG 2, severe weight loss) and advanced age, we started the patient on S-1 monotherapy at a dose of 35 mg/m2 bid for 4 consecutive weeks followed by a 2-week rest. Follow-up study after 4 treatment cycles revealed disappearance of the lymphadenopathy of the perigastric and celiac axis with diminished extension of the stomach mass. The patient had a partial response (PR) with a 72% tumor reduction, according to the Response Evaluation Criteria in Solid Tumors (RECIST). His performance status was improved to an ECOG 1 and he gained 7 kg. A curative (R0) resection was achieved with a radical total gastrectomy and D2 dissection. The pathological stage was pT3N2M0, stage IIIB. In conclusion, S-1 neoadjuvant chemotherapy aided in the treatment of gastric cancer in this patient.
참고문헌 (15)
- Roder JD, "Prognostic factors in gastric carcinoma: results of the German Gastric Carcinoma Study 1992", Cancer, 72, pp.2089~2097 (1993)
- Rougier P, "Preoperative chemotherapy of locally advanced gastric cancer", ANNALS OF ONCOLOGY, 5(3), pp.59~68 (1994)
- Wilke H, "Achterrath W, Lenaz L, Knipp H. Preoperative chemotherapy in locally advanced and nonresectable gastric cancer: a phase II study with etoposide, doxorubicin, and cisplatin", JOURNAL OF CLINICAL ONCOLOGY, 7, pp.1318~1326 (1989)
- Forshaw MJ, "Neoadjuvant chemotherapy for locally advanced carcinoma of the lower oesophagus and oesophago-gastric junction", European Journal of Surgical Oncology, 32, pp.1114~1118 (2006)
- Cascinu S, "High curative resection rate with weekly cisplatin, 5-fluorouracil, epidoxorubicin, 6S-leucovorin, gluathione and filgrastim in patients with locally advanced unresectable gastric cancer", British Journal of Cance, 90, pp.1521~1525 (2004)
- Schuhmacher CP, "Neoadjuvant therapy for patients with locally advanced gastric carcinoma with etoposide, doxorubicin, and cisplatinum: closing results after 5 years of follow-up", Cancer, 91, pp.918~927 (2001)
- Shirasaka T, "Development of a novel form of an oral 5-fluorouracil derivative (S-1) directed to the potentiation of the tumor selective cytotoxicity of 5-fluorouracil by two biochemical modulators", Anti-Cancer Drugs, 7, pp.548~557 (1996)
- Sakata Y, "Late phase II study of novel oral fluoropyrimidine anticancer drug S-1 (1 M tegafur-0.4 M gimestat-1 M otastat potassium) in advanced gastric cancer patients", EUROPEAN JOURNAL OF CANCER, 34, pp.1715~1720 (1998)
- Sugimachi K, "An early phase II study of oral S-1, a newly developed 5-fluorouracil derivative for advanced and recurrent gastrointestinal cancers", ONCOLOGY, 57, pp.202~210 (1999)
- Kochi M, "Neoadjuvant chemotherapy with S-1 and CDDP in advanced gastric cancer", Journal of Cancer Research and Clinical Oncology, 132, pp.781~785 (2006)
- Satoh S, "Retrospective analysis of 45 consecutive patients with advanced gastric cancer treated with neoadjuvant chemotherapy using an S-1", CDDP combination, 2006, pp.9, 129~135
- Iwahashi M, "Complete response of highly advanced gastric cancer with peritoneal dissemination after new combined chemotherapy of S-1 and low-dose cisplatin: report of a case", Oncology, 61, pp.16~22 (2001)
- Yamamoto Y, "A case report of advanced cardiac cancer showing a complete response to TS-1 as neoadjuvant chemotherapy", Gan to kagaku ryoho. Cancer & chemotherapy, 31, pp.579~583 (2004)
- Becker K, "Neoadjuvant chemotherapy for patients with locally advanced gastric carcinoma: effect on tumor cell microinvolvement of regional lymph nodes", Cancer, 85, pp.1484~1489 (1999)
- Kawai H, "Efficacy and safety profile of S-1 in patients with metastatic gastric cancer in clinical practice: results from a postmarketing survey", Gastric Cancer, 6(1) (2003)