Safety, efficacy and pharmacokinetics of S-1 in a hemodialysis patient with advanced gastric cancer |
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Authors: | Nariaki Tomiyama Muneaki Hidaka Hideo Hidaka Yukihiro Kawano Norihisa Hanada Hideki Kawaguchi Kazuhiko Arimori Chizuko Nakamura |
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Institution: | 1. Department of Pharmacy, Izumi General Medical Center, 520, Myojin-cho, Izumi-shi, Kagoshima, 899-0131, Japan 2. Department of Pharmaceutical Sciences, Kyushu University of Health and Welfare, Nobeoka, Japan 3. Department of Urology, Kagoshima City Hospital, Kagoshima, Japan 4. Department of Urology, Izumi General Medical Center, Kagoshima, Japan 5. Department of Surgery, Izumi General Medical Center, Kagoshima, Japan 6. Division of Radiology, Department of Medical Technology, Izumi General Medical Center, Kagoshima, Japan 7. Department of Pharmacy, University of Miyazaki Hospital, Miyazaki, Japan
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Abstract: | Purpose The safety and efficacy of S-1 in hemodialysis patients have not been established. We evaluated the safety and efficacy and pharmacokinetics of S-1 in a hemodialysis patient with advanced gastric cancer. Patient A 66-year-old Japanese man with chronic renal failure, who had undergone hemodialysis three times a week for 3 years. Based on the diagnosis of stage IV gastric cancer, S-1 therapy was started. S-1 was administered 11 times at a daily dose of 23.5 mg/m2 (40 mg/body) after hemodialysis, followed by a rest. One course was a period of 28 days. Blood samples were obtained after the first administration of S-1 and before beginning the fourth course. The concentration of 5-FU was determined by high-performance liquid chromatography. Results Area under the concentration–time curve (AUC) of 5-FU was 2647.2 ng h/mL after administration of S-1 of 23.5 mg/m2 (40 mg/body). During the S-1 treatment, serious adverse events such as neutropenia were not observed; however, decreases in hemoglobin level were observed (grade 3). The treatment was well tolerated. After the second course of chemotherapy, the primary lesion showed a partial response and lymph node metastases and liver metastases showed stable disease. Conclusions Our results suggest that S-1 is an important treatment option for patients with hemodialysis with advanced gastric cancer. |
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