A feasibility study of postoperative adjuvant chemotherapy with fluoropyrimidine S-1 in patients with stage II-IIIA non-small cell lung cancer

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  • Tsuboi Mitsuhiro
    Department of Thoracic, Endocrine Surgery and Oncology, Institute of Biomedical Sciences, Tokushima University Graduate School
  • Kondo Kazuya
    Department of Oncological Medical Services, Institute of Biomedical Sciences, Tokushima University Graduate School
  • Takizawa Hiromitsu
    Department of Thoracic, Endocrine Surgery and Oncology, Institute of Biomedical Sciences, Tokushima University Graduate School
  • Kawakita Naoya
    Department of Thoracic, Endocrine Surgery and Oncology, Institute of Biomedical Sciences, Tokushima University Graduate School
  • Sawada Toru
    Department of Thoracic, Endocrine Surgery and Oncology, Institute of Biomedical Sciences, Tokushima University Graduate School
  • Toba Hiroaki
    Department of Thoracic, Endocrine Surgery and Oncology, Institute of Biomedical Sciences, Tokushima University Graduate School
  • Kawakami Yukikiyo
    Department of Thoracic, Endocrine Surgery and Oncology, Institute of Biomedical Sciences, Tokushima University Graduate School
  • Yoshida Mitsuteru
    Department of Thoracic, Endocrine Surgery and Oncology, Institute of Biomedical Sciences, Tokushima University Graduate School
  • Ishikura Hisashi
    Department of general thoracic surgery, Tokushima Red Cross Hospital
  • Kimura Suguru
    Department of surgery, East Tokushima Medical Center
  • Tangoku Akira
    Department of Thoracic, Endocrine Surgery and Oncology, Institute of Biomedical Sciences, Tokushima University Graduate School

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  • A feasibility study of postoperative adjuvant chemotherapy with fluoropyrimidine S‐1 in patients with stage II‐IIIA non‐small cell lung cancer

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<p>Background:Adjuvant chemotherapy with uracil tegafur (UFT) improved survival among patients with completely resected stage I lung adenocarcinoma. S‐1, an oral dihydropyrimidine dehydrogenase (DPD)‐inhibitory 5‐fluorouracil, is a more potent DPD inhibitor than UFT;therefore, we hypothesized that postoperative adjuvant chemotherapy with S‐1 would be effective for advanced non‐small cell lung cancer (NSCLC). We conducted a feasibility study of S‐1 as postoperative adjuvant chemotherapy in patients with curatively resected pathological stage bold I back 10 bold I and bold I back 10 bold I back 20 bold I A NSCLC. Methods:Adjuvant chemotherapy consisted of 9 courses (4‐week administration, 2‐week withdrawal) of S‐1 at 80‐120 mg/body per day. Twenty‐four patients with completely resected NSCLC were enrolled in this study from November 2007 through December 2010. The primary endpoint was the rate of completion of the scheduled adjuvant chemotherapy. The secondary endpoints were safety, overall survival, and relapse‐free survival. Results:Five patients were censored because of disease recurrence. The planned 9 courses of S‐1 were administered to completion in 8 patients. Twelve patients completed more than 70% of the planned courses. Grade 3 adverse reactions, such as elevated total bilirubin (4.2%) and pneumonitis (4.2%), were observed, but there were no Grade 4 adverse reactions. Patients who completed more than 70% of the 9 courses demonstrated better overall survival than those who completed less than 70%. Conclusion:Postoperative administration of S‐1 may be possible with few severe adverse events as adjuvant chemotherapy for patients with curatively resected pathological stage bold I back 10 bold I ‐bold I back 10 bold I back 20 bold I A NSCLC. J. Med. Invest. 65:90‐95, February, 2018</p>

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