Usefulness of the Outpatient Chemotherapy Regimen of S-1 Followed by Weekly Paclitaxel for Far Advanced Gastric Cancer

To evaluate outpatient treatment, as well as the clinical effect of 1M tegafur-0.4M gimestat-1M otastat potassium(S-1) followed by weekly Paclitaxel(PTX) for patients with far advanced inoperable gastric cancer, we analyzed retrospectively the appropriateness of outpatient anticancer chemotherapy from the standards of overall survival and time without symptom and toxicity(TWiST) as a quality-adjusted survival analysis. A total of 18 patients with advanced inoperable gastric cancer were treated with S-1 as first line single-agent chemotherapy from May 1, 2000 to September 30, 2000 at the Niigata City General Hospital. S-1 (60mg-120mg/m^2/orally twice daily on Days 1-28 followed by a 14 days rest/course) was repeated until progression of the disease. After the first line was completed, a second line, PTX (60mg-80mg/m^2/infused on Day 1/week, three weeks and withdrawal for a week), was started two weeks later. PTX was repeated until progression of the disease. No severe adverse events (≧National Cancer Institute Common Toxicity Criteria ((NCICTC) grade 3) were observed. The median survival time (MST) overall including the first line and second line was 295 days. The hospitalization period was 60.0 days throughout the median of the total hospital stay and the rate was 25.6% in overall survival. There was no significant difference by histological type, metastasis, liver metastasis, or peritoneal dissemination. The median duration of TWiST as quality-adjusted survival analysis was 353 days in good performance status (PS) and 72 days in poor PS. S-1 followed by weekly PTX for various advanced inoperable gastric cancers appears to be a promising, appropriate, and well-tolerated anticancer chemotherapy regimen in an outpatient setting