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Comparison of 2- and 4-week S-1 administration as adjuvant chemotherapy for advanced gastric cancer

Authors :
Yoshimasa Akashi
Katsuji Hisakura
Tsuyoshi Enomoto
Yusuke Ohara
Michitaka Honda
Koichi Ogawa
Tatsuya Oda
Akinao Kaneda
Osamu Shimomura
Kazuhiro Takahashi
Soshi Hori
Satoshi Inagawa
Yohei Owada
Source :
International Journal of Clinical Oncology. 25:1807-1813
Publication Year :
2020
Publisher :
Springer Science and Business Media LLC, 2020.

Abstract

Background A 4-week administration of tegafur/gimeracil/oteracil (S-1) followed by a 2-week rest is the standard adjuvant chemotherapy for surgically resected advanced gastric cancer. This study aimed to evaluate the oncological feasibility of a 2-week S-1 administration followed by a 1-week rest, which is frequently applied in clinical practice to reduce toxicity and improve drug adherence. Methods We retrospectively enrolled patients with stage II/III gastric cancer who received S-1 adjuvant chemotherapy following radical gastrectomy from 2006 to 2016 in three institutions. Two-week and 4-week regimen cohorts were compared for relative dose intensity (RDI) as a primary outcome, and treatment completion rate, adverse event incidence, overall survival (OS), and relapse-free survival (RFS) as secondary outcomes. Confounders were adjusted for using propensity score matching (PSM). Results One hundred and thirty-four patients received the 2-week regimen and 121 patients received the 4-week regimen. Ninety-five patients were extracted from each group after PSM. The RDIs of S-1 in the 2-week and 4-week cohorts were 73.5 and 69.9%, respectively (p = 0.35), which were not significantly different. The treatment completion rate (54.7 vs. 53.7%, p = 1.0), incidence of grade ≥3 adverse events (7.4 vs. 12.6%, p = 0.33), 3-year OS (76.4 vs. 82.7%, p = 0.78), and 3-year RFS (71.3 vs. 73.4%, p = 0.70) did not significantly differ between both cohorts. Conclusions The 2-week S-1 adjuvant chemotherapy could not improve drug adherence in terms of RDI, but its relapse rates were not significantly different compared with those of the 4-week regimen. The 2-week regimen might be considered as an option depending on the patient’s status.

Details

ISSN :
14377772 and 13419625
Volume :
25
Database :
OpenAIRE
Journal :
International Journal of Clinical Oncology
Accession number :
edsair.doi.dedup.....c2a212fb01fcee5c240814e8b21abea0