Risk factors for discontinuation of S-1 adjuvant chemotherapy for gastric cancer

Hitoshi Kawazoe, Maya Shimasaki, Masaki Ueno, Satomi Sumikawa, Shingo Takatori, Hiroyuki Namba, Motohira Yoshida, Koichi Sato, Yoh Kojima, Yuji Watanabe, Toshihide Moriguchi, Akihiro Tanaka, Hiroaki Araki

Research output: Contribution to journalArticle

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Abstract

Purpose: The aim of this study was to clarify the risk factors for discontinuing tegafur/gimeracil/oteracil potassium (S-1) adjuvant chemotherapy following gastrectomy in patients with gastric cancer. Methods: We retrospectively investigated patients with curatively-resected gastric cancer who received S-1 adjuvant chemotherapy. S-1 was administered orally at 80-120 mg/day, depending on body surface area, on days 1-28 every 6 weeks for 1 year. The dose and treatment schedule were modified at the clinicians' discretion, according to toxicity. Results: Seventy-one patients were included in the study, 26 of whom discontinued S-1 therapy. The relapse-free survival rates in the S-1-completed and S-1-discontinuation groups at 5 years post-surgery were 88.1% and 55.8%, respectively. The overall survival rates in the S-1-completed and S-1-discontinuation groups at 5 years post-surgery were 89.4% and 59.8%, respectively. The hazard ratios for relapse and death were significantly lower in the S-1-completed group compared with those in the S-1-discontinuation group (0.18; p < 0.001 and 0.19; p=0.002, respectively). Multivariate logistic regression analysis revealed that S-1 discontinuation was significantly associated with an initial overdose of S-1, having stage I cancer, creatinine clearance < 66 mL/min, and a side effect of nausea. Conclusions: These results suggest that assessing renal function to avoid initial overdose of S-1, together with the early management of side effects, may support the continuation of S-1 adjuvant chemotherapy in patients with gastric cancer.

Original languageEnglish
Pages (from-to)464-469
Number of pages6
JournalJournal of Cancer
Volume6
Issue number5
DOIs
Publication statusPublished - 2015 Jan 1
Externally publishedYes

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Adjuvant Chemotherapy
Stomach Neoplasms
Survival Rate
Recurrence
Body Surface Area
Gastrectomy
Nausea
Creatinine
Appointments and Schedules
Potassium
Logistic Models
Regression Analysis
Kidney
Therapeutics
Neoplasms

Keywords

  • Adjuvant chemotherapy
  • Discontinuation
  • Gastric cancer
  • Risk factor
  • Tegafur/gimeracil/oteracil potassium (S-1)

ASJC Scopus subject areas

  • Oncology

Cite this

Kawazoe, H., Shimasaki, M., Ueno, M., Sumikawa, S., Takatori, S., Namba, H., ... Araki, H. (2015). Risk factors for discontinuation of S-1 adjuvant chemotherapy for gastric cancer. Journal of Cancer, 6(5), 464-469. https://doi.org/10.7150/jca.11189

Risk factors for discontinuation of S-1 adjuvant chemotherapy for gastric cancer. / Kawazoe, Hitoshi; Shimasaki, Maya; Ueno, Masaki; Sumikawa, Satomi; Takatori, Shingo; Namba, Hiroyuki; Yoshida, Motohira; Sato, Koichi; Kojima, Yoh; Watanabe, Yuji; Moriguchi, Toshihide; Tanaka, Akihiro; Araki, Hiroaki.

In: Journal of Cancer, Vol. 6, No. 5, 01.01.2015, p. 464-469.

Research output: Contribution to journalArticle

Kawazoe, H, Shimasaki, M, Ueno, M, Sumikawa, S, Takatori, S, Namba, H, Yoshida, M, Sato, K, Kojima, Y, Watanabe, Y, Moriguchi, T, Tanaka, A & Araki, H 2015, 'Risk factors for discontinuation of S-1 adjuvant chemotherapy for gastric cancer', Journal of Cancer, vol. 6, no. 5, pp. 464-469. https://doi.org/10.7150/jca.11189
Kawazoe, Hitoshi ; Shimasaki, Maya ; Ueno, Masaki ; Sumikawa, Satomi ; Takatori, Shingo ; Namba, Hiroyuki ; Yoshida, Motohira ; Sato, Koichi ; Kojima, Yoh ; Watanabe, Yuji ; Moriguchi, Toshihide ; Tanaka, Akihiro ; Araki, Hiroaki. / Risk factors for discontinuation of S-1 adjuvant chemotherapy for gastric cancer. In: Journal of Cancer. 2015 ; Vol. 6, No. 5. pp. 464-469.
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abstract = "Purpose: The aim of this study was to clarify the risk factors for discontinuing tegafur/gimeracil/oteracil potassium (S-1) adjuvant chemotherapy following gastrectomy in patients with gastric cancer. Methods: We retrospectively investigated patients with curatively-resected gastric cancer who received S-1 adjuvant chemotherapy. S-1 was administered orally at 80-120 mg/day, depending on body surface area, on days 1-28 every 6 weeks for 1 year. The dose and treatment schedule were modified at the clinicians' discretion, according to toxicity. Results: Seventy-one patients were included in the study, 26 of whom discontinued S-1 therapy. The relapse-free survival rates in the S-1-completed and S-1-discontinuation groups at 5 years post-surgery were 88.1{\%} and 55.8{\%}, respectively. The overall survival rates in the S-1-completed and S-1-discontinuation groups at 5 years post-surgery were 89.4{\%} and 59.8{\%}, respectively. The hazard ratios for relapse and death were significantly lower in the S-1-completed group compared with those in the S-1-discontinuation group (0.18; p < 0.001 and 0.19; p=0.002, respectively). Multivariate logistic regression analysis revealed that S-1 discontinuation was significantly associated with an initial overdose of S-1, having stage I cancer, creatinine clearance < 66 mL/min, and a side effect of nausea. Conclusions: These results suggest that assessing renal function to avoid initial overdose of S-1, together with the early management of side effects, may support the continuation of S-1 adjuvant chemotherapy in patients with gastric cancer.",
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AU - Namba, Hiroyuki

AU - Yoshida, Motohira

AU - Sato, Koichi

AU - Kojima, Yoh

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AU - Moriguchi, Toshihide

AU - Tanaka, Akihiro

AU - Araki, Hiroaki

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AB - Purpose: The aim of this study was to clarify the risk factors for discontinuing tegafur/gimeracil/oteracil potassium (S-1) adjuvant chemotherapy following gastrectomy in patients with gastric cancer. Methods: We retrospectively investigated patients with curatively-resected gastric cancer who received S-1 adjuvant chemotherapy. S-1 was administered orally at 80-120 mg/day, depending on body surface area, on days 1-28 every 6 weeks for 1 year. The dose and treatment schedule were modified at the clinicians' discretion, according to toxicity. Results: Seventy-one patients were included in the study, 26 of whom discontinued S-1 therapy. The relapse-free survival rates in the S-1-completed and S-1-discontinuation groups at 5 years post-surgery were 88.1% and 55.8%, respectively. The overall survival rates in the S-1-completed and S-1-discontinuation groups at 5 years post-surgery were 89.4% and 59.8%, respectively. The hazard ratios for relapse and death were significantly lower in the S-1-completed group compared with those in the S-1-discontinuation group (0.18; p < 0.001 and 0.19; p=0.002, respectively). Multivariate logistic regression analysis revealed that S-1 discontinuation was significantly associated with an initial overdose of S-1, having stage I cancer, creatinine clearance < 66 mL/min, and a side effect of nausea. Conclusions: These results suggest that assessing renal function to avoid initial overdose of S-1, together with the early management of side effects, may support the continuation of S-1 adjuvant chemotherapy in patients with gastric cancer.

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