Abstract
The Adjuvant Chemotherapy Trial of S-1 for Gastric Cancer established oral S-1 administration for 1year as the standard postoperative adjuvant chemotherapy for gastric cancer in Japan. We conducted a multicenter cooperative prospective study comparing daily and alternate-day S-1 administration as postoperative adjuvant therapy for gastric cancer. Patients with Stage II or III gastric cancer who underwent curative surgery were randomly assigned to receive standard daily S-1 administration [group A: 80-120mg/day S-1 depending on body surface area (BSA); days 1-28 every 6weeks for 1year] or alternate-day administration (group B: 80-120mg/day S-1 depending on BSA; alternate days for 15months). Treatment completion rate was the primary endpoint, and relative dose intensity and safety, overall survival, and relapse-free survival (RFS) were secondary endpoints. Seventy-three patients were enrolled. The treatment completion rate was 72.2% in group A and 91.8% in group B; the relative dose intensity was 67.5% in group A and 81.2% in group B; and compliance was better in group B. Digestive system adverse effects were less frequent in group B than in group A. Median follow-up time was 2.8years; 3-year survival rate was 69.6% in group A and 87.3% in group B; and 3-year RFS rate was 76.4% in group A and 73.1% in group B. Our data show improved compliance and fewer adverse effects with alternate-day S-1 administration, which appears to be a more sustainable option for adjuvant chemotherapy for Stage II or III gastric cancer.
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