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

International Journal of Clinical Oncology volume 25, pages1807–1813(2020)Cite this article

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.

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Acknowledgements

This study was approved by T-CReDO (Tsukuba Clinical Research and Development Organization) (H29-320).

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Affiliations

  1. Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan

    Koichi Ogawa, Yoshimasa Akashi, Yohei Owada, Yusuke Ohara, Katsuji Hisakura, Tsuyoshi Enomoto, Osamu Shimomura, Kazuhiro Takahashi & Tatsuya Oda

  2. Department of Minimally Invasive Surgical and Medical Oncology, Fukushima Medical University, Fukushima, Japan

    Michitaka Honda

  3. Department of Gastroenterological Surgery, Tsukuba Medical Center Hospital, Tsukuba, Ibaraki, Japan

    Satoshi Inagawa

  4. Department of Surgery, Southern-Tohoku General Hospital, Fukushima, Japan

    Akinao Kaneda & Soshi Hori

Authors
  1. Koichi Ogawa
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  2. Michitaka Honda
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  3. Yoshimasa Akashi
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  4. Satoshi Inagawa
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  5. Akinao Kaneda
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  6. Soshi Hori
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  7. Yohei Owada
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  8. Yusuke Ohara
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  9. Katsuji Hisakura
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  10. Tsuyoshi Enomoto
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  11. Osamu Shimomura
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  12. Kazuhiro Takahashi
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  13. Tatsuya Oda
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Correspondence to Koichi Ogawa.

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Ogawa, K., Honda, M., Akashi, Y. et al. Comparison of 2- and 4-week S-1 administration as adjuvant chemotherapy for advanced gastric cancer. Int J Clin Oncol 25, 1807–1813 (2020). https://doi.org/10.1007/s10147-020-01719-5

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Keywords

  • Gastric cancer
  • S-1
  • Adjuvant chemotherapy
  • 2-week administration
  • Propensity score-matched analysis