Total gastrectomy increases the incidence of grade III and IV toxicities in patients with gastric cancer receiving adjuvant TS-1 treatmentReportar como inadecuado




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World Journal of Surgical Oncology

, 11:287

First Online: 01 November 2013Received: 09 April 2013Accepted: 18 October 2013

Abstract

BackgroundWe aimed to evaluate the safety and efficacy of TS-1 adjuvant chemotherapy in Taiwanese patients with gastric cancer.

MethodsWe included in this study patients with locally advanced gastric cancer who received adjuvant TS-1 or 5-fluorouracil chemotherapy after curative surgery and extended lymph node dissection between 1 June 2008 and 31 December 2012 at Chang Gung Memorial Hospital. Patient characteristics, tumor features, safety profiles and compliance with TS-1 treatment were retrospectively analyzed from medical charts.

ResultsForty patients received adjuvant chemotherapy with TS-1 and 193 with 5-fluorouracil within the study period. The 1- and 2-year overall survival rates were 90.6% and 87% in the TS-1 group and 95.4% and 86.8% in the 5-fluorouracil group P = 0.34. The 1- and 2-year disease-free survival rates were 90.6% and 74.7% in the TS-1 group and 88% and 75.7% in the 5-fluorouracil group P = 0.66. In the TS-1 group, tumor recurrence was more frequent in those with >15 metastatic lymph nodes than ≤15. Overall, 78.9%, 74.3%, 62.1% and 56% of patients underwent TS-1 treatment for at least 3, 6, 9 and 12 months, respectively. The most common adverse events of TS-1 were skin hyperpigmentation 55%, diarrhea 27.5%, dizziness 27.5% and leucopenia 20%. Severe adverse events SAEs; grade III or IV toxicity were diarrhea 7.5%, stomatitis 7.5%, leukopenia 5%, vomiting 2.5%, anorexia 2.5% and dizziness 2.5%. Patients who underwent total gastrectomy had a significantly greater risk of TS-1-related SAEs than patients who underwent subtotal gastrectomy 40% versus 8%, P = 0.014.

ConclusionsThe incidence of SAEs during TS-1 therapy was more common in Taiwanese patients with gastric cancer who underwent total gastrectomy compared with those who underwent subtotal gastrectomy. Clinicians must be aware of and able to manage these SAEs to maximize patient compliance with adjuvant TS-1.

KeywordsAdjuvant chemotherapy Compliance Gastric cancer Safety profile TS-1 Abbreviations5FU5-fluorouracil

ACTS-GCAdjuvant Chemotherapy Trial of TS-1 for Gastric Cancer

AJCCAmerican Joint Committee on Cancer

D2Extended lymph node dissection.

Electronic supplementary materialThe online version of this article doi:10.1186-1477-7819-11-287 contains supplementary material, which is available to authorized users.

Wen-Chi Chou, Chia-Lun Chang contributed equally to this work.

An erratum to this article is available at http:-dx.doi.org-10.1186-1477-7819-11-310.

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Autor: Wen-Chi Chou - Chia-Lun Chang - Keng-Hao Liu - Jun-Te Hsu - Hung-Chih Hsu - Wen-Chi Shen - Yu-Shin Hung - Jen-Shi Chen

Fuente: https://link.springer.com/



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