Advertisement

Gastric Cancer

, Volume 6, Supplement 1, pp 40–44 | Cite as

Neoadjuvant chemotherapy with S-1 for scirrhous gastric cancer: a pilot study

  • Taira Kinoshita
  • Masaru Konishi
  • Toshio Nakagohri
  • Kazuo Inoue
  • Tatsuya Oda
  • Shinichiro Takahashi
  • Narikazu Boku
  • Atsushi Ohtsu
  • Shigeaki Yoshida
Article

Abstract

We conducted a pilot study using S-1 (TS-1®), a novel oral derivative of 5-fluorouracil, as neoadjuvant chemotherapy for potentially resectable scirrhous gastric cancer. The neoadjuvant chemotherapy consisted of two courses (each, 4-week administration and 2-week withdrawal) of S-1 at 100–120 mg/body per day. Five patients were enrolled in this pilot study and underwent resection. The response rate for the neoadjuvant chemotherapy was 60% (three partial response [PR]; two stable disease [SD]). Three of the five patients received curative resection; the other two patients received noncurative resection because of localized peritoneal dissemination and positive results on cytological examination of the abdominal washing. No toxicity of grade 3 or more was exhibited during the two courses of chemotherapy. Pathological examination of the resected specimens revealed a marked reduction in the distribution of viable cancer cells in the stomach in the three patients with PR. In one of these patients, pathological findings suggestive of the possibility of disappearance of the cancer cells in the perigastric and paraaortic lymph nodes were noted. Because of the unexpectedly high response to S-1, we consider that the efficacy of S-1 as neoadjuvant chemotherapy for scirrhous gastric cancer should be verified by phase II and III trials.

Key words

Scirrhous gastric cancer S-1 Neoadjuvant chemotherapy 

References

  1. 1.
    Furukawa, H, Hiratsuka, M, Iwanaga, T, Imaoka, S, Ishikawa, O 1997Extended surgery — left upper abdominal exenteration plus Appleby's method — for type 4 gastric carcinomaAnn Surg Oncol420914PubMedGoogle Scholar
  2. 2.
    Takahashi, S, Kinoshita, T, Konishi, M, Nakagohri, T, Inoue, K, Ono, M,  et al. 2001Phase II study of sequential high-dose methotrexate and fluorouracil combined with doxorubicin as a neoadjuvant chemotherapy for scirrhous gastric cancerGastric Cancer41927PubMedCrossRefGoogle Scholar
  3. 3.
    Sugimachi, K, Maehara, Y, Horikoshi, N, Shimada, Y, Sakata, Y, Miyachi, Y,  et al. 1999An early phase II study of oral TS-1, a newly developed 5-fluorouracil derivative for advanced and recurrent gastrointestinal cancersOncology5720210PubMedCrossRefGoogle Scholar
  4. 4.
    Sakata, Y, Ohtsu, A, Horikoshi, N, Sugimachi, K, Mitachi, Y, Taguchi, T 1998Late phase II study of novel oral fluoropyrimidine anticancer drug TS-1 (1 M tegafur-04 M gimestat-1 M otastat potassium) in advanced gastric cancer patientsEur J Cancer34171520PubMedCrossRefGoogle Scholar
  5. 5.
    Koizumi, W, Kurihara, M, Nakano, S, Hasegawa, K 2000Phase II study of TS-1, a novel oral derivative of 5-fluorouracil, in advanced gastric cancerOncology581917PubMedCrossRefGoogle Scholar
  6. 6.
    Gastric, Japanese 1998Cancer Association. Japanese classification of gastric carcinoma, 2nd English editionGastric Cancer11024Google Scholar
  7. 7.
    Mai, M, Ogino, T, Ueda, H, Ooi, A, Takahashi, Y, Sawaguchi, K,  et al. 1990Study on neoadjuvant chemotherapy of Borrmann 4 type carcinoma of the stomach and its clinical significanceNippon Gan Chiryo Gakkai Shi (J Jpn Soc Cancer Ther)2558697Google Scholar
  8. 8.
    Maeda, O, Iwase, H, Mamiya, N, Nakamura, M, Mizuno, T, Nishio, Y,  et al. 2000A case of scirrhous cancer of the stomach which survived for more than 5 years after neoadjuvant chemotherapy with UFT (uracil and tegafur) and cisplatinIntern Med3923944PubMedGoogle Scholar
  9. 9.
    Eriguchi, M, Osada, I, Fujii, Y, Takeda, Y, Yoshizaki, I, Akiyama, N,  et al. 1997Pilot study for preoperative administration of 1-OHP to patients with advanced scirrhous type gastric cancerBiomed Pharmacother5121720PubMedGoogle Scholar
  10. 10.
    Suga, S, Iwase, H, Shimada, M, Nishio, Y, Ichihara, T, Ichihara, S,  et al. 1996Neoadjuvant chemotherapy in scirrhous cancer of the stomach using uracil, tegafur and cisplatinIntern Med359306PubMedGoogle Scholar

Copyright information

© International and Japanese Gastric Cancer Associations 2003

Authors and Affiliations

  • Taira Kinoshita
    • 1
  • Masaru Konishi
    • 1
  • Toshio Nakagohri
    • 1
  • Kazuo Inoue
    • 1
  • Tatsuya Oda
    • 1
  • Shinichiro Takahashi
    • 1
  • Narikazu Boku
    • 2
  • Atsushi Ohtsu
    • 2
  • Shigeaki Yoshida
    • 2
  1. 1.Department of Surgical OncologyNational Cancer Center Hospital EastChibaJapan
  2. 2.Department of Medical OncologyNational Cancer Center Hospital EastChibaJapan

Personalised recommendations