Abstract
PurposeThe aim of this prospective, noncomparative, observational case series was to evaluate changes to meibomian gland morphology in patients undergoing S-1 chemotherapy with the use of noninvasive meibography and analytical software.MethodsPatients aged ≥20 years and undergoing S-1 chemotherapy were included. Ophthalmologic examinations were performed before S-1 administration (Pre) and at 1, 3, and 6 months afterward (1M, 3M, and 6M, respectively). Meibography images were analyzed using analytical software. The ratio of the total meibomian gland area relative to the whole measurement area (meibomian gland area ratio [MGAR]) and the rate of change to the MGAR (MGAR at Pre, 1M, 3M, or 6M)/(MGAR at Pre) × 100 were calculated.ResultsIn total, 28 eyelids of seven men (mean age, 68.9 ± 6.3 years) were studied. The mean MGAR of the upper and lower eyelids significantly decreased at 3M (P = 0.0246 and P = 0.00892, respectively) and 6M (P < 0.0001 and P < 0.0001, respectively). There was a significant negative correlation between the cumulative dose of S-1 and the rate of change to the MGAR of the upper (P < 0.0001, r = −0.77) and lower (P < 0.0001, r = −0.785) eyelids. However, there was no other significant difference.ConclusionsThe meibomian gland area decreased after S-1 administration with significant correlations between the rate of change to the MGAR and the mean cumulative dose of S-1.Translational RelevanceSystemic S-1 administration decreased the MGAR in a dose-dependent manner; thus, clinicians should pay more attention to morphologic changes to the meibomian glands during early treatment with S-1.
Highlights
The combination drug S-1 is an oral anticancer agent for treatment of malignant tumors[1] of the stomach,[2] pancreas,[3] colon,[4] and breast.[5]
Oteracil potassium is a phosphorylation inhibitor that blocks 5-FU generation in the gastrointestinal tract, where otherwise higher levels would result in higher toxicity. 5-FU is metabolized and decomposed by the same pathway and the same enzyme as uracil in vivo
S-1 monotherapy was used as an adjuvant for all patients with gastric cancer after surgery, and chemotherapy was administered for 1 year
Summary
The combination drug S-1 (tegafur, gimeracil, and oteracil potassium) is an oral anticancer agent for treatment of malignant tumors[1] of the stomach,[2] pancreas,[3] colon,[4] and breast.[5] Tegafur is a prodrug of 5-fluorouracil (5-FU) with anticancer effects. Oteracil potassium is a phosphorylation inhibitor that blocks 5-FU generation in the gastrointestinal tract, where otherwise higher levels would result in higher toxicity. Metabolism of 5-FU in the liver produces two active metabolites: fluorouridine triphosphate, which disrupts RNA function, and fluorodeoxyuridine monophosphate, which inhibits DNA synthesis, resulting in anticancerous effects.[6] these effects on RNA and DNA are restricted to cancerous cells, but TVST j 2018 j Vol 7 j No 6 j Article 37
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