Treatment with an oral fluoropyrimidine, S-1, plus cisplatin in patients who failed postoperative gemcitabine treatment for pancreatic cancer: a pilot study
Treatment with an oral fluoropyrimidine, S-1, plus cisplatin in patients who failed postoperative gemcitabine treatment for pancreatic cancer: a pilot study
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DOI：
10.1007/s10147-007-0674-x
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发表时间：
2007-08-01
影响因子：
3.3
通讯作者：
Miyazaki, Masaru
中科院分区：
文献类型：
--
作者：
Togawa, Akira;Yoshitomi, Hideyuki;Miyazaki, Masaru
背景本研究旨在评估吉西他滨耐药胰腺癌患者中S-1联合顺铂（CDDP）的缓解率和毒性。17例组织学诊断为浸润性胰腺导管癌的患者入组本研究。尽管给予吉西他滨，所有患者的胰腺癌复发率仍在增加。13例行胰腺切除术，2例行胆肠吻合加胃空肠吻合术。口服S-1（80 mg/m2/d），连续21天，停药14天。CDDP（40 mg/m2）溶于500 ml生理盐水，第8天静脉滴注。该方案每5周重复一次，直至出现疾病进展、不可接受的毒性或患者拒绝继续治疗。5例（29.4%）患者达到部分缓解，2例（11.8%）患者病情稳定。在治疗开始时血清碳水化合物抗原（CA）19-9水平升高的15名患者中的5名（33.3%）中，CA 19 -9降低超过50%。中位生存时间为10个月（范围为20个月），分别有63.7%和31.9%的患者在6个月和12个月时存活。15例患者的主要不良反应包括1级或2级胃肠道毒性。仅1例患者（5.9%）发生3级白细胞减少。S-1联合CDDP对吉西他滨耐药胰腺癌具有良好的疗效，且毒性易于控制。需要在胰腺癌患者中进一步研究该方案，尤其是与吉西他滨相比。
Background. This study set out to evaluate, in patients with gemcitabine-resistant pancreatic cancer, the response rate and toxicity of S-1 plus cisplatin (CDDP).Methods. Seventeen patients with histologically diagnosed invasive ductal pancreatic cancer were enrolled in this study. All patients had growing recurrent pancreas cancer despite the administration of gemcitabine. Thirteen patients underwent pancreatectomy, and 2 underwent choledochojejunostomy and gastrojejunostomy without pancreatectomy. S-1 (80mg/m(2) per day) was orally administered for 21 consecutive days, followed by a 14-day rest period. CDDP (40 mg/m(2)) in 500 ml saline was administered by intravenous drip on day 8. This schedule was repeated every 5 weeks until the occurrence of disease progression, unacceptable toxicities, or the patient's refusal to continue.Results. Five (29.4%) patients achieved a partial response and 2 (11.8%) had stable disease. In 5 of 15 patients (33.3%) who had elevated serum carbohydrate antigen (CA)19-9 levels at the start of treatment the CA19-9 was reduced by more than 50%. The median survival time was 10 months (range, 20 months), with 63.7% and 31.9% of patients alive at 6 and 12 months, respectively. Major adverse reactions in the 15 patients included gastrointestinal toxicities of grade 1 or 2. Only one patient (5.9%) developed grade 3 leucopenia.Conclusion. S-1 with CDDP has a promising effect against gemcitabine-resistant pancreatic cancer, with easily manageable toxicities. Further investigation of this regimen is warranted in patients with pancreatic cancer, especially in comparison with gemcitabine.