Phase II Study of Chemoradiotherapy With S-1 and Low-Dose Cisplatin for Inoperable Advanced Gastric Cancer

Yoshiro Saikawa, Tetsuro Kubota, Koshi Kumagai, Rieko Nakamura, Koichiro Kumai, Naoyuki Shigematsu, Atsushi Kubo, Masaki Kitajima, Yuukou Kitagawa

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Purpose: The results of a pilot study using S-1/low-dose cisplatin/radiotherapy led us to hypothesize that the initial chemoradiotherapy regimen would induce a 70% efficacy rate with a 10% pathologic complete response rate. Patients and Methods: Only patients with unresectable or incurable advanced gastric cancer were eligible. The patients received induction S-1 and cisplatin therapy with radiotherapy followed by chemotherapy alone. Results: Of the 30 patients recruited and assessed, 29 were eligible for clinical evaluation of measurable lesions. The response rate was 65.5%, with 19 with a partial response, 8 with no change, and 2 with progressive disease of 29 patients. Of the 30 patients recruited, 10 (33.3%) underwent stomach resection and D2 LN dissections. The pathologic complete response rate was 13.3% (4 patients), and the R0 resection rate was 100% (10 patients). The survival analysis showed a median survival time of 25 months. Grade 3 toxicity occurred in 66.7% for leukocytopenia, 33.3% for thrombocytopenia, 23.3% for nausea and appetite loss, and 6.7% for anemia, diarrhea, and renal dysfunction. Although all the patients had been hospitalized with a poor performance status with a giant tumor, 97% (29 of 30) could be discharged after the first cycle, resulting in an improvement in quality of life. Conclusion: Chemoradiotherapy could be a powerful regimen for controlling tumor progression in advanced gastric cancer, improving patients' quality of life with tolerable toxicity. A complete histologic response rate of >10% would be expected, even for large tumors with metastatic lesions.

Original languageEnglish
Pages (from-to)173-179
Number of pages7
JournalInternational Journal of Radiation Oncology Biology Physics
Volume71
Issue number1
DOIs
Publication statusPublished - 2008 May 1

Fingerprint

Chemoradiotherapy
Cisplatin
Stomach Neoplasms
cancer
dosage
tumors
toxicity
lesions
radiation therapy
Radiotherapy
nausea
Quality of Life
anemias
stomach
Neoplasms
dissection
Leukopenia
Appetite
chemotherapy
Survival Analysis

Keywords

  • Chemoradiotherapy
  • Cisplatin
  • Gastric cancer
  • S-1

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation

Cite this

Phase II Study of Chemoradiotherapy With S-1 and Low-Dose Cisplatin for Inoperable Advanced Gastric Cancer. / Saikawa, Yoshiro; Kubota, Tetsuro; Kumagai, Koshi; Nakamura, Rieko; Kumai, Koichiro; Shigematsu, Naoyuki; Kubo, Atsushi; Kitajima, Masaki; Kitagawa, Yuukou.

In: International Journal of Radiation Oncology Biology Physics, Vol. 71, No. 1, 01.05.2008, p. 173-179.

Research output: Contribution to journalArticle

Saikawa, Yoshiro ; Kubota, Tetsuro ; Kumagai, Koshi ; Nakamura, Rieko ; Kumai, Koichiro ; Shigematsu, Naoyuki ; Kubo, Atsushi ; Kitajima, Masaki ; Kitagawa, Yuukou. / Phase II Study of Chemoradiotherapy With S-1 and Low-Dose Cisplatin for Inoperable Advanced Gastric Cancer. In: International Journal of Radiation Oncology Biology Physics. 2008 ; Vol. 71, No. 1. pp. 173-179.
@article{b1fe00a6c72c41ebb6efe6dcaa42c520,
title = "Phase II Study of Chemoradiotherapy With S-1 and Low-Dose Cisplatin for Inoperable Advanced Gastric Cancer",
abstract = "Purpose: The results of a pilot study using S-1/low-dose cisplatin/radiotherapy led us to hypothesize that the initial chemoradiotherapy regimen would induce a 70{\%} efficacy rate with a 10{\%} pathologic complete response rate. Patients and Methods: Only patients with unresectable or incurable advanced gastric cancer were eligible. The patients received induction S-1 and cisplatin therapy with radiotherapy followed by chemotherapy alone. Results: Of the 30 patients recruited and assessed, 29 were eligible for clinical evaluation of measurable lesions. The response rate was 65.5{\%}, with 19 with a partial response, 8 with no change, and 2 with progressive disease of 29 patients. Of the 30 patients recruited, 10 (33.3{\%}) underwent stomach resection and D2 LN dissections. The pathologic complete response rate was 13.3{\%} (4 patients), and the R0 resection rate was 100{\%} (10 patients). The survival analysis showed a median survival time of 25 months. Grade 3 toxicity occurred in 66.7{\%} for leukocytopenia, 33.3{\%} for thrombocytopenia, 23.3{\%} for nausea and appetite loss, and 6.7{\%} for anemia, diarrhea, and renal dysfunction. Although all the patients had been hospitalized with a poor performance status with a giant tumor, 97{\%} (29 of 30) could be discharged after the first cycle, resulting in an improvement in quality of life. Conclusion: Chemoradiotherapy could be a powerful regimen for controlling tumor progression in advanced gastric cancer, improving patients' quality of life with tolerable toxicity. A complete histologic response rate of >10{\%} would be expected, even for large tumors with metastatic lesions.",
keywords = "Chemoradiotherapy, Cisplatin, Gastric cancer, S-1",
author = "Yoshiro Saikawa and Tetsuro Kubota and Koshi Kumagai and Rieko Nakamura and Koichiro Kumai and Naoyuki Shigematsu and Atsushi Kubo and Masaki Kitajima and Yuukou Kitagawa",
year = "2008",
month = "5",
day = "1",
doi = "10.1016/j.ijrobp.2007.09.010",
language = "English",
volume = "71",
pages = "173--179",
journal = "International Journal of Radiation Oncology Biology Physics",
issn = "0360-3016",
publisher = "Elsevier Inc.",
number = "1",

}

TY - JOUR

T1 - Phase II Study of Chemoradiotherapy With S-1 and Low-Dose Cisplatin for Inoperable Advanced Gastric Cancer

AU - Saikawa, Yoshiro

AU - Kubota, Tetsuro

AU - Kumagai, Koshi

AU - Nakamura, Rieko

AU - Kumai, Koichiro

AU - Shigematsu, Naoyuki

AU - Kubo, Atsushi

AU - Kitajima, Masaki

AU - Kitagawa, Yuukou

PY - 2008/5/1

Y1 - 2008/5/1

N2 - Purpose: The results of a pilot study using S-1/low-dose cisplatin/radiotherapy led us to hypothesize that the initial chemoradiotherapy regimen would induce a 70% efficacy rate with a 10% pathologic complete response rate. Patients and Methods: Only patients with unresectable or incurable advanced gastric cancer were eligible. The patients received induction S-1 and cisplatin therapy with radiotherapy followed by chemotherapy alone. Results: Of the 30 patients recruited and assessed, 29 were eligible for clinical evaluation of measurable lesions. The response rate was 65.5%, with 19 with a partial response, 8 with no change, and 2 with progressive disease of 29 patients. Of the 30 patients recruited, 10 (33.3%) underwent stomach resection and D2 LN dissections. The pathologic complete response rate was 13.3% (4 patients), and the R0 resection rate was 100% (10 patients). The survival analysis showed a median survival time of 25 months. Grade 3 toxicity occurred in 66.7% for leukocytopenia, 33.3% for thrombocytopenia, 23.3% for nausea and appetite loss, and 6.7% for anemia, diarrhea, and renal dysfunction. Although all the patients had been hospitalized with a poor performance status with a giant tumor, 97% (29 of 30) could be discharged after the first cycle, resulting in an improvement in quality of life. Conclusion: Chemoradiotherapy could be a powerful regimen for controlling tumor progression in advanced gastric cancer, improving patients' quality of life with tolerable toxicity. A complete histologic response rate of >10% would be expected, even for large tumors with metastatic lesions.

AB - Purpose: The results of a pilot study using S-1/low-dose cisplatin/radiotherapy led us to hypothesize that the initial chemoradiotherapy regimen would induce a 70% efficacy rate with a 10% pathologic complete response rate. Patients and Methods: Only patients with unresectable or incurable advanced gastric cancer were eligible. The patients received induction S-1 and cisplatin therapy with radiotherapy followed by chemotherapy alone. Results: Of the 30 patients recruited and assessed, 29 were eligible for clinical evaluation of measurable lesions. The response rate was 65.5%, with 19 with a partial response, 8 with no change, and 2 with progressive disease of 29 patients. Of the 30 patients recruited, 10 (33.3%) underwent stomach resection and D2 LN dissections. The pathologic complete response rate was 13.3% (4 patients), and the R0 resection rate was 100% (10 patients). The survival analysis showed a median survival time of 25 months. Grade 3 toxicity occurred in 66.7% for leukocytopenia, 33.3% for thrombocytopenia, 23.3% for nausea and appetite loss, and 6.7% for anemia, diarrhea, and renal dysfunction. Although all the patients had been hospitalized with a poor performance status with a giant tumor, 97% (29 of 30) could be discharged after the first cycle, resulting in an improvement in quality of life. Conclusion: Chemoradiotherapy could be a powerful regimen for controlling tumor progression in advanced gastric cancer, improving patients' quality of life with tolerable toxicity. A complete histologic response rate of >10% would be expected, even for large tumors with metastatic lesions.

KW - Chemoradiotherapy

KW - Cisplatin

KW - Gastric cancer

KW - S-1

UR - http://www.scopus.com/inward/record.url?scp=41749093634&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=41749093634&partnerID=8YFLogxK

U2 - 10.1016/j.ijrobp.2007.09.010

DO - 10.1016/j.ijrobp.2007.09.010

M3 - Article

VL - 71

SP - 173

EP - 179

JO - International Journal of Radiation Oncology Biology Physics

JF - International Journal of Radiation Oncology Biology Physics

SN - 0360-3016

IS - 1

ER -