Surgery alone, adjuvant tegafur/gimeracil/octeracil (S-1), or platinum-based chemotherapies for resectable gastric cancer: real-world experience and a propensity score matching analysis
| Autor: | Hsuan-Yi Huang, Chia Jui Yen, Ying-Jui Chao, I-Ting Liu, I-Shu Chen, Ting-Kai Liao, Yan Shen Shan, Chih-Chieh Yen |
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| Rok vydání: | 2021 |
| Předmět: |
0301 basic medicine
Cancer Research medicine.medical_specialty Resectable gastric cancer Pyridines medicine.medical_treatment Observation Tegafur 03 medical and health sciences 0302 clinical medicine Carcinoembryonic antigen Stomach Neoplasms Surgical oncology Genetics Humans Medicine Stage (cooking) Propensity Score Lymph node RC254-282 Adjuvant Aged Retrospective Studies Platinum biology business.industry Research Neoplasms. Tumors. Oncology. Including cancer and carcinogens Cancer S-1 Middle Aged medicine.disease Surgery Drug Combinations Oxonic Acid 030104 developmental biology medicine.anatomical_structure Oncology Chemotherapy Adjuvant 030220 oncology & carcinogenesis Propensity score matching biology.protein business medicine.drug |
| Zdroj: | BMC Cancer BMC Cancer, Vol 21, Iss 1, Pp 1-14 (2021) |
| ISSN: | 1471-2407 |
| Popis: | Background Adjuvant chemotherapy has changed the paradigm in resectable gastric cancer. S-1 is an oral chemotherapeutic with promising efficacy in Asia. However, comparisons with close observation or platinum-based doublets post D2 gastrectomy have been less reported, notably on real-world experiences. Methods We retrospectively evaluated patients with D2-dissected stage IB-III gastric cancer who received S-1 (S-1, n = 67), platinum-based doublets (P, n = 145) and surgery with close observation (OBS, n = 221) from Jan 2008 to Oct 2018. A propensity score matching was used to compare for recurrence-free (RFS) and overall survivals (OS) in patients who had a locally-advanced disease (T3–4 or lymph node-positive). Adverse reactions, dosage, and associated factors for S-1 are also discussed. Results In a median follow-up time of 51.9 months, adjuvant S-1 monotherapy was associated with an intermediate survival as compared with P and OBS (median RFS/OS: S-1 vs. P, 20.9/35.8 vs. 31.2/50.5 months, HR = 1.76/2.14, p = 0.021/0.008; S-1 vs. OBS, 24.4/40.2 vs. 20.7/27.0 months, HR = 0.62/0.55, p = 0.041/0.024). The survival differences were more prominent in patients with N2–3 diseases. S-1 was well-tolerated with a relative dose intensity of 73.6%, a median duration of 8.3 months and associated with less adverse reactions as compared with P. S-1 monotherapy was selected by physicians based on age, lymph node stage, serum carcinoembryonic antigen and disease stage. Conclusions Adjuvant S-1 correlated with intermediate survival outcomes between OBS and P but conferred fewer adverse reactions as compared with P. Patients with a moderate risk of recurrence had comparable survivals when treated with S-1 while platinum-based doublets were favored in advanced cases. The study provides additional information about adjuvant S-1 in patients with selected risk of recurrence. |
| Databáze: | OpenAIRE |
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