替吉奥联合奥沙利铂一线治疗晚期肝内胆管癌患者疗效和安全性评价

目的 评价替吉奥联合奥沙利铂（SOX）方案治疗晚期肝内胆管癌患者的临床疗效和安全性。方法 19例晚期肝内胆管癌患者一线接受SOX方案化疗,即第1天给予奥沙利铂130 mg/m2,静脉滴注（2 h内滴完）,第1～14天给予替吉奥80 mg.m2-1.d-1,分2次口服,休息7天,即每21天为1个周期。在化疗结束后评价疗效和毒副反应。结果 19例患者均接受2个周期以上的SOX方案化疗,平均（4.3±1.8）周期;PR 3例（15.8％）,SD 7例（36.8％）,PD 9例（47.4％）。临床获益10例（52.6％）;平均疾病进展时间为（5.1±3.6）月,平均总生存时间为（8.5±6.5）月;主要的毒副反应为骨髓抑制17例、恶心/呕吐7例、外周神经毒性3例,均为I～II级。结论 SOX方案一线治疗晚期肝内胆管癌患者有一定的疗效,毒性反应可耐受,值得临床进一步研究。     

Neoadjuvant chemotherapy with S-1 and CDDP in advanced gastric cancer

Purpose This retrospective study evaluated the effects of neoadjuvant chemotherapy in advanced gastric cancer.Methods Between 2002 and 2005, we treated 14 patients with advanced gastric cancer (involvement of more than five nodes or tumor invasion into pancreas) and 25 patients with Stage III gastric cancer. The group of 14 patients with advanced gastric cancer received combination chemotherapy with S-1 and cis-diamminedichloroplatinum (CDDP) as a neoadjuvant chemotherapy (NAC). This regimen was repeated every 5 weeks for a total of 2–5 cycles. The 25 patients with Stage III gastric cancer was carried surgery alone (SA). All patients underwent extensive surgery, including gastrectomy, and D2 lymphadenectomy. The rate of response and overall survival in the two groups were compared.Results All patients of NAC group completed the planned regimens of chemotherapy and surgery. Patients of the NAC group had a response rate of 78.6% (95% confidence interval 57.1–100.0%). The most common adverse effect was leukocytopenia (42.9%). However, only four patients (28.6%) had upper Grade 2 leukocytopenia, and all recovered promptly. Postoperative complications were not significant differentiated between NAC and SA group of patients (7.2 vs. 4.0%). Patients in the NAC group had a significantly better survival than those in the SA group (P = 0.03). The median survival has not been reached after 26.9 months of median follow-up for patients in the NAC group. 1-, 2-, and 3-year survival rates were 92.3, 92.3, and 61.5%, respectively. NAC was identified as an independent prognostic factor in all patients (P = 0.018).Conclusion Neoadjuvant chemotherapy with TS-1 + CDDP improves the survival in patients with advanced gastric cancer.     

Apatinib combined with S-1 as second-line therapy in advanced gastric cancer

Advanced gastric cancer (AGC) patients are not tolerant to the toxicities of traditional chemotherapy and its second-line therapeutic regimens are limited. The aim of the present study is to evaluate the efficacy and safety of apatinib combined with S-1 as the second-line therapy for AGC patients.Patients with AGC were enrolled in this study. Patients received oral apatinib (250 mg to 500 mg once daily) and S-1(40 mg/m² twice daily) on days 1–14. Each cycle was 28 days and one course of treatment consisted of 2 cycles. Clinical efficacy and adverse events (AEs) were observed. Kaplan–Meier method was used for survival analysis.From November 2015 to December 2017, 58 AGC patients who failed first-line chemotherapy were enrolled and assessed retrospectively. According to the Response Evaluation Criteria in Solid Tumors (RECIST) standard, all patients were evaluable for response. None achieved CR, and 10 (17.2%) achieved PR (95% CI 7.2%–27.3%). SD was observed in 58.6% (34/58) of patients (95% CI 45.6%–71.7%) and NR in 24.1% (14/58) of patients (95% CI 12.8%–35.5%). The objective response rate (ORR) and the disease control rate (DCR) were 17.2% and 75.8% respectively. The median progression-free survival (PFS) and median overall survival (OS) were 143.1 days (95% CI 121.7–164.5) and 211.6 days (95% CI 162.9–219.7) respectively. The multivariate analysis showed that the ECOG PS was the independent factor of PFS and OS for AGC patients (PFS: HR = 3.565, 95% CI: 2.25–5.65, P < .001; OS: HR = 3.676, 95% CI: 2.29–5.89, P < .001). The main AEs were fatigue (72.4%), hypertension (46.6%), and leukopenia (48.3%).Apatinib combined with S-1 showed promising efficiency and was well tolerated as the second-line therapy for AGC patients. ECOG PS was the independent factor of PFS and OS for AGC patients. AEs were moderate and controllable, and leukopenia or hypertension was predictable factors for the PFS and OS of AGC patients.     

Eight-year survival after advanced gastric cancer treated with S-1 followed by surgery

We report a case of advanced gastric cancer, with cervical, axillary, and abdominal paraaortic lymph node metastases, that was successfully treated with chemotherapy and surgery. The disease was initially considered unresectable, and the patient was treated with orally administered S-1. Chemotherapy was effective, and all lymph node metastases disappeared after 6 courses. After 27 mo of chemotherapy, the patient underwent curative surgery, with subtotal gastrectomy and lymph node dissection. Histopathologic...     

Surgical resection of advanced gastric cancer following trastuzumab/oxaliplatin/capecitabine combination therapy

Late-stage gastric adenocarcinoma patients have a poor prognosis because of high recurrence rates. To improve long-term outcomes, perioperative chemotherapies are combined with surgery. Human epidermal growth factor receptor 2 (HER2) overexpression had been noted in gastric cancer; therefore, trastuzumab has been used occasionally in this setting. A 63-year-old male Chinese patient, who was diagnosed with adenocarcinoma in the gastric antrum, as well as lymph node metastases along the left gastric and hepatic artery, and left adrenal area, was admitted to our hospital. HER2 expression was positive, and cluster amplification was detected in a fluorescence in situ hybridization assay. The patient received three cycles of a neoadjuvant trastuzumab/oxaliplatin /capecitabine regimen. He subsequently underwent distal gastrectomy, D2+ lymphadenectomy, left adrenalectomy, cholecystectomy and Billroth II anastomosis. Treatment was continued with another five postoperative cycles of the same medication and trastuzumab application for 1 year. No recurrence has been observed 18 mo after the operation. Trastuzumab as perioperative and adjuvant medication, in combination with oxaliplatin and capecitabine for a HER2-overexpressing advanced gastric adenocarcinoma, led to recurrence-free survival of at least 18 mo after surgery.     

奥沙利铂联合希罗达或替加氟方案治疗老年晚期胃癌的临床观察

目的比较老年晚期胃癌应用奥沙利铂联合希罗达或替加氟方案化疗的疗效和安全性。方法 72例老年晚期胃癌按收治的时间顺序交替分为两组,A组用奥沙利铂联合希罗达方案化疗,B组用奥沙利铂联合替加氟加亚叶酸钙方案化疗,两组均化疗3个周期,比较两组的疗效和毒副反应。结果 A组化疗有效率36.1%,B组有效率38.9%,两组间疗效差异无统计学意义;两组初治均比复治有效率略高,但差异无统计学意义。毒副反应主要为血液学毒性、胃肠道反应和外周神经毒性、手足综合征。两组的白细胞减少及外周神经毒性无统计学差异。A组共发生血小板减少共12例,发生率33.3%,其中有2例Ⅲ度血小板减少;B组发生血小板减少共6例,发生率16.7%,未发生Ⅲ、Ⅳ度血小板减少。A组血小板减少发生率明显高于B组,两组有显著统计学差异(P<0.005)。B组胃肠道反应发生率为77.8%,且有2例Ⅲ度胃肠道反应,明显高于A组的61.1%,两者差异有统计学意义(P<0.05)。A组共发生手足综合征12例,其中2例为Ⅲ度,发生率为33.3%;B组共发生手足综合征5例,均为Ⅰ度,发生率为13.9%,两组手足综合征的发生率差异有统计学意义(P<0.05)。结论老年晚期胃癌应用奥沙利铂联合希罗达或替加氟方案化疗均取得较好的疗效,耐受性可。希罗达组的血液学毒性及手足综合征发生率较高,卡莫氟组胃肠道反应高于对照组。     

替吉奥联合腹腔热灌注顺铂、甘露聚糖肽对晚期胃癌合并腹腔积液患者的疗效观察

目的研究替吉奥联合腹腔热灌注顺铂、甘露聚糖肽对晚期胃癌合并腹腔积液患者的疗效。方法选取2012年2月至2015年3月在深圳市第四人民医院接受治疗的晚期胃癌合并腹腔积液患者84例,以数字法随机分为A、B、C组,每组各28例。A组予替吉奥口服联合腹腔热灌注顺铂+甘露聚糖肽,B组予腹腔热灌注顺铂+甘露聚糖肽,C组予腹腔热灌注顺铂化学治疗,对比3组的疗效。结果 A组治疗有效率、生活质量总改善率显著高于B组和C组,A组患者6个月生存率显著高于B组(P均0.05)。结论替吉奥联合腹腔热灌注顺铂、甘露聚糖肽对晚期胃癌合并腹腔积液患者的疗效显著,且预后较好。     

Polymorphisms of XRCC1 gene and risk of gastric cardiac adenocarcinoma

X-ray repair cross complementing 1 (XRCC1) protein plays an important role in base excision repair. Single nucleotide polymorphisms (SNPs) in XRCC1 gene may affect DNA repairing ability and genetic susceptibility to cancer. This study was designed to investigate the correlation of XRCC1 Arg194Trp Arg280His and Arg399Gln SNPs with the risk of gastric cardiac adenocarcinoma (GCA). Genotypes were analyzed by polymerase chain reaction-restriction fragment length polymorphism assay in 455 patients with GCA and 650 age- and sex-matched controls. We did not find any significant difference in allele and genotype distributions of Arg194Trp Arg399Gln between the groups ( P  > 0.05). However, a significant increase in GCA risk was seen among smokers if they carried at least one XRCC1 280His ( Arg280His  +  His280His ) genotype (odds ratio = 1.59, 95% confidence interval = 1.01–2.51) compared with smokers not carrying these genotype. Our results indicated that XRCC1 Arg194Trp and Arg 399 Gln SNPs might not be associated with the risk of GCA. However, smokers with His allele at codon 280 had a significantly increased risk of GCA.     

CDH1基因多态性与胃腺癌患者舌苔辨证的相关性

目的:研究CDH1基因多态性与胃腺癌患者舌苔辨证的关系.方法:应用连接酶检测反应,对387例胃腺癌患者和392例健康对照的CDH1基因的4个位点进行基因分型,并且按中医舌诊辨证要求,由中医诊断学专家进行舌色、舌质的诊断.结果:胃腺癌组不按时吃饭的比例高于对照组(2=9.124,P=0.010),胃腺癌组与对照组相比饮食口味偏咸(2=74.409,P<0.001),胃腺癌组的吸烟率高于对照组(2=18.019,P<0.001),胃腺癌组经常吃豆制品的频率明显低于对照组(2=10.669,P=0.014),并且其经常吃新鲜水果的频率明显低于对照组(2=59.905,P<0.001).rs13689、rs17690554位点携带突变基因型并且苔色为黄色的个体在病例组的分布频率明显高于对照组(2=4.064,P=0.044;2=5.868,P=0.015).两组人群在各位点同一基因型的不同苔质的差异均具有统计学意义(P<0.050).结论:CDH1基因多态性与胃腺癌患者舌苔辨证有一定关联,本研究结果有助于揭示胃腺癌患者基因位点突变与舌苔形成和变化的科学内涵.     

S-1 combined with oxaliplatin as first line chemotherapy for chinese advanced gastric cancer patients

Background/Aims: To evaluate the efficacy and safety profile of S-1 combined with oxaliplatin (SOX) against unresectable advanced or metastatic gastric cancer. Methodology: Oxaliplatin was administered intravenously at 100mg/m2 for two hours on day 1 and S-1 was administered b.i.d. at 80mg/m2/day on days 1-14 followed by a 7-day rest during the 3-week schedule. Results: All 51 patients were assessed for efficacy and adverse events. The response and disease control rates were 41% and 90%, respectively. The response rate was significantly improved in patients with ECOG performance status of no more than 1, elevated CEA levels or unresected primary cancers. The median follow-up time was 11.8 months, the median time to progression was 6.8 months, the median overall survival was 11.8 months and the 1-year survival rate was 47.4%. Patients with diffused type exhibited significantly decreased time to progression and overall survival. The grade 3/4 adverse events were hematological toxicities, including neutropenia (13.7%), thrombocytopenia (13.7%) and anemia (11.8%). The incidence of grade 3/4 non-hematological events was low (≤2%). Conclusions: The SOX regimen (oxaliplatin, 100mg/m2 d1; S-1, 80mg/m2/day, b.i.d. d1-14, q3w) provided a favorable efficacy and safety profile in Chinese patients with advanced gastric cancer.     

林州市贲门癌P53和PCNA与癌旁肠上皮化生的关系

目的:探讨贲门腺癌(gastric cardia adeno- carcinoma,GCA)的P53和PCNA分子学特征与癌旁肠上皮化生(intestinal metaplasia,IM)的关系.方法:采用ABC免疫组织化学分析(immuno- histochemistry,IHC)法研究了70例癌旁含IM和不含IM的贲门癌P53和PCNA蛋白表达变化的特征.结果:癌旁含IM的GCA中P53蛋白阳性高表达率明显高于癌旁不含IM的GCA(33.33% vs 4.65%,P<0.01),而PCNA蛋白在两组中的阳性高表达率(74.07%和79.07%)比较无显著性差异(P>0.05).结论:癌旁含IM和不含IM的GCA形态相似,但可能具有不同的分子基础.     

Efficacy of docetaxel combined with oxaliplatin and fluorouracil against stage III/IV gastric cancer

AIM: To investigate the clinical efficacy and toxic effects of neoadjuvant chemotherapy using docetaxel combined with oxaliplatin and fluorouracil for treating stage III/IV gastric cancer.METHODS: A total of 53 stage III/IV gastric cancer patients were enrolled into the study and treated with neoadjuvant chemotherapy. Two of the cases were excluded. The program was as follows: 75 mg/m² docetaxel and 85 mg/m² oxaliplatin on day 1 and 1500 mg/m² fluorouracil on days 1 to 3 for three weeks.RESULTS: The tumour changes, postoperative remission rate, changes in the symptoms and adverse reactions were observed. The overall clinical efficacy (complete remission + partial remission) of the neoadjuvant chemotherapy was 62.7%. R0 radical resection was performed on 60.8% of the patients, with a remission rate (pathological complete response + pathological subtotal response + pathological partial response) of 74.2%. The Karnofksy score improved in 42 cases. The toxicity reactions mostly included myelosuppression, followed by gastrointestinal mucosal lesions, nausea, vomiting and diarrhoea.CONCLUSION: Neoadjuvant chemotherapy consisting of docetaxel combined with oxaliplatin and fluorouracil is effective for stage III/IV gastric cancer. However, the treatment is associated with a high incidence of bone marrow suppression, which should be managed clinically.     

达沙替尼联合奥沙利铂协同抑制胃癌细胞增殖和迁移

目的:评价Src酪氨酸激酶抑制剂达沙替尼联合奥沙利铂抑制胃癌细胞体外增殖、迁移等恶性生物学行为的效应。方法:实时定量-聚合酶链反应(RT-PCR)及蛋白质印迹法(Western blot)检测Src及其活性形式p-Src在胃癌细胞株中的基础表达;蛋白质印迹技术观察不同剂量奥沙利铂作用于胃癌细胞或作用不同时间后,细胞内Src及p-Src的变化规律;细胞计数试剂盒(CCK-8)方法评价胃癌细胞暴露于不同浓度奥沙利铂和达沙替尼后的生长抑制率,分别计算2种药物的半数抑制浓度(IC50),并使用Calcusyn 2.0软件计算联合作用指数(CI);细胞集落形成实验、流式细胞术和划痕实验观察上述药物对胃癌细胞体外增殖、细胞周期、凋亡和迁移能力的影响。结果:胃癌细胞株SGC-7901、BGC-823、MKN-28的p-Src/Src基础表达比值较高;奥沙利铂可明显上调胃癌细胞SGC-7901、BGC-823、MKN-28的p-Src,并呈时间依赖性(r2=0.96、0.85、0.94);达沙替尼和奥沙利铂在胃癌细胞中的CI均     

替吉奥联合紫杉醇周疗对晚期老年胃癌患者的临床疗效评价

目的评价替吉奥(S-1)联合紫杉醇周疗治疗晚期老年胃癌患者的近期疗效及毒副反应物。方法将广西横县人民医院确诊的38例晚期老年胃癌患者随机分为2组,治疗组20例,采用紫杉醇联合替吉奥化疗:紫杉醇60 mg/m2,第1、8、15 d用药,替吉奥胶囊80 mg/m2,2次/d,连续口服14 d,28 d为1个周期;对照组18例,采用FP方案:顺铂15 mg/m2,第1~5天静点,5-Fu 750mg/m2,第1~5天静点,28 d为1个周期。两组患者至少治疗2个周期后评价其疗效及毒副反应。结果治疗组与对照组的有效率(RR)、疾病控制率(DCR)、1年生存率分别为40.0%、75.0%、55.0%和22.2%、50.0%、38.9%,差异无统计学意义(P0.05);治疗组患者KPS改善情况优于对照组(P0.05);治疗组的胃肠道反应及Ⅲ~Ⅳ度骨髓抑制明显低于对照组(P0.05)。结论替吉奥口服联合紫杉醇周疗方案化疗有效率高,老年患者耐受性好,是老年晚期胃癌患者值得选择的化疗方案。     

S-1-based combination therapy vs S-1 monotherapy in advanced gastric cancer:A meta-analysis

AIM:To assess the efficacy and safety of combination therapy based on S-1,a novel oral fluoropyrimidine,vs S-1 monotherapy in advanced gastric cancer(AGC).METHODS:We searched PubMed,EMBASE and the Cochrane Library for eligible studies published before March 2013.Our analysis identified four randomized controlled trials involving 790 participants with AGC.The outcome measures were overall survival(OS),progression-free survival(PFS),overall response rate(ORR)and grade 3-4 adverse events.RESULTS:Meta-analysis showed that S-1-based combination therapy significantly improved OS(HR=0.77,95%CI:0.66-0.91,P=0.002),PFS(HR=0.58,95%CI:0.46-0.72,P=0.000)and ORR(OR=2.23,95%CI:1.54-3.21,P=0.000).Sensitivity analysis further confirmed this association.Lower incidence of grade 3-4 leucopenia(OR=4.06,95%CI:2.11-7.81),neutropenia(OR=3.94,95%CI:2.1-7.81)and diarrhea(OR=2.41,95%CI:1.31-4.44)was observed in patients with S-1 monotherapy.CONCLUSION:S-1-based combination therapy is superior to S-1 monotherapy in terms of OS,PFS and ORR.S-1 monotherapy is associated with less toxicity.     

Etiologic factors of gastric cardiac adenocarcinoma among men in Taiwan

AIM: To elucidate etiologic associations between Helicobacter pylori ( H pylori), lifestyle, environmental factors and gastric cardiac adenocarcinoma (GCA) among men.METHODS: A hospital-based case-control study was conducted in Taiwan from 2000 to 2009.All cases were newly confirmed as primary GCA.Five controls were selected matching with age, sex, and admission date to each case.Participants were informed of potential risk factors with a structured questionnaire by trained interviewers during hospitalization and provided a blood sample for the determination of H pylori infection.Odds ratio (OR) and 95% confidence interval (95% CI) were used to evaluate risk, and a multivariate conditional logistic regression model was performed.RESULTS: All participants recruited for this study were men, consisting of 41 cases and 205 controls.Results of the univariate analysis showed that significant factors associated with the etiology of GCA included H pylori (OR = 2.69, 95% CI = 1.30-5.53), cigarette smoking (OR = 2.28, 95% CI = 1.05-4.96), working or exercising after meals (OR = 3.26, 95% CI = 1.31-8.11), salted food (OR = 2.51, 95%CI = 1.08-6.11), fresh vegetables (OR = 0.28, 95% CI = 0.09-0.80), fruits (OR = 0.19, 95% CI = 0.04-0.89), and rice as principal food (OR = 0.53, 95% CI = 0.30-0.85).Multivariate conditional logistic regression models indicated that a significantly elevated risk of contracting GCA was associated with working or exercising after meals (OR = 3.18, 95% CI = 1.23-9.36) and H pylori infection (OR = 2.93, 95% CI = 1.42-6.01).In contrast, the consumption of fresh vegetables (OR = 0.22, 95% CI = 0.06-0.83), fruits (OR = 0.28, 95% CI = 0.09-0.79) and rice as principal food (OR = 0.48, 95% CI = 0.24-0.93) remained as significant beneficial factor associated with GCA.CONCLUSION: Working or exercising after meals and H pylori infection increase the risk of GCA, but higher intakes of rice, fresh vegetables and fruits reduce the risk.     

RASSF1A基因启动子区甲基化在贲门腺癌、食管下段鳞癌组织中的变化及临床意义

目的:比较RASSF1A基因甲基化在贲门腺癌、食管下段鳞癌不同病理阶段组织中的共性和差异.方法:33例贲门腺癌和36例食管下段鳞癌手术切除标本纳入本研究,每例标本选取癌组织,癌旁不典型增生组织(距癌3-5 cm),癌旁正常组织(距癌>5 cm)组织各1块,采用甲基化特异性PCR检测RASSF1A基因启动子区的甲基化情况...     

替吉奥胶囊联合奥沙利铂治疗晚期胃癌的临床观察

［摘要］　目的　观察替吉奥胶囊联合奥沙利铂治疗晚期胃癌的疗效及不良反应。方法　将60例晚期胃癌患者随机分为治疗组30例和对照组30例。治疗组给予替吉奥胶囊联合奥沙利铂方案治疗,对照组给予奥沙利铂联合亚叶酸钙和5-氟尿嘧啶方案治疗,全部患者均接受至少4个周期的化疗。结果　治疗组完全缓解0例,部分缓解19例,稳定10例,进展1例;对照组完全缓解0例,部分缓解9例,稳定17例,进展4例。两组主要不良反应为血液学毒性、胃肠道反应和神经系统毒性,治疗组的不良反应发生率明显低于对照组(P<0.05）。结论　替吉奥胶囊联合奥沙利铂治疗晚期胃癌安全有效。     

Single nucleotide polymorphism in DNA methyltransferase 3B promoter and its association with gastric cardiac adenocarcinoma in North China

AIM: To investigate the association between single nucleotide polymorphism (SNP) in promoter of the DNA methyltrans-ferase 3B(DNMT3B) gene and risk for development and lymphatic metastasis of gastric cardiac adenocarcinoma (GCA). METHODS: The hospital based case-control study included 212 GCA patients and 294 control subjects without overt cancer. The DNMT3B SNP was genotyped by PCR and restriction fragment length polymorphism (RFLP) analysis. RESULTS: The C/C genotype was not detected in both GCA patients and controls. In control subjects, the frequency of T/T and C/T genotypes was 94.9% and 5.1% respectively, and that of T and C alleles was 97.4% and 2.6%, respectively. The genotype and allelotype distribution in the GCA patients was not significantly different from that in controls (P=0.34 and 0.33, respectively). When stratified by smoking status and family history of upper gastrointestinal cancer, significant difference in the genotype distribution was not observed between GCA patients and controls. The distribution of DNMT3B genotypes in GCA patents with or without lymphatic metastasis did not show significant difference (P= 0.42). CONCLUSION: The distribution of DNMT3B SNP in North China is distinct from that in Caucasians. Although this SNP has been associated with susceptibility to lung, head, neck and breast cancer, it may not be used as a stratification marker to predict susceptibility and lymphatic metastasis of GCA, at least in the population of North China.     

Three-weekly s-1 monotherapy as first-line treatment in elderly patients with recurrent or metastatic gastric cancer

Background/Aims

Elderly patients with advanced gastric cancer (AGC) have generally been excluded from clinical trials, and there are few data available on the treatment of these patients. The efficacy of palliative S-1 monotherapy as a first-line treatment regimen for elderly patients has not been well elucidated.

Methods

For this study, 25 AGC patients were enrolled between January 1, 2007 and March 31, 2009; 4 cases were recurrent AGC and 21 cases were metastatic AGC at the time of diagnosis. These patients received S-1 therapy at a dose of 40 mg/m² twice daily for 14 days every 3 weeks. All of the patients were older than 70 years.

Results

The median follow-up duration, the median progression-free survival, and the overall survival time were 8.7 months (range, 4.9 to 12.5 months), 4.9 months (range, 3.5 to 6.3 months), and 10.8 months (range, 6.6 to 15.0 months), respectively. Grade 3/4 nonhematologic toxicities were rare. Grade 3/4 neutropenia was noted in two patients. The partial response rate was 21.7% and stable disease was observed in 34.8% of the patients. Two patients (8%) died due to chemotherapy-associated toxicity during treatment (septic shock/intracranial hemorrhage).

Conclusions

Oral S-1 chemotherapy seems to be effective as a first-line treatment regimen for elderly patients with metastatic or recurrent AGC. However, elderly patients receiving S-1 treatment should undergo continuous toxicity monitoring, since they are highly susceptible to adverse effects.