S-1 Based Doublet as an Adjuvant Chemotherapy for Curatively Resected Stage III Gastric Cancer: Results from the Randomized Phase III POST Trial
Cancer Research and Treatment 2019³â 51±Ç 1È£ p.1 ~ p.11
ÀÌÃæ±Ù(Lee Choong-Kun) - Yonsei University College of Medicine Department of Internal Medicine
Á¤¹Î±Ô(Jung Min-Kyu) - Yonsei University College of Medicine Department of Internal Medicine
±èÈ¿¼Û(Kim Hyo-Song) - Yonsei University College of Medicine Department of Internal Medicine
Á¤Àΰæ(Jung In-Kyung) - Yonsei University College of Medicine Department of Biostatistics
½Åµ¿º¹(Shin Dong-Bok) - Gachon University Gil Hospital Department of Internal Medicine
°¼®À±(Kang Seok-Yun) - Ajou University School of Medicine Department of Hematology-Oncology
Àå´ë¿µ(Zang Dae-Young) - Hallym University College of Medicine Hallym University Medical Center Department of Internal Medicine
±è±âÇâ(Kim Ki-Hyang) - Inje University Busan Paik Hospital Department of Internal Medicine
À̹®Èñ(Lee Moon-Hee) - Inha University School of Medicine Department of Internal Medicine
±èºÀ¼®(Kim Bong-Seog) - Veterans Health Service Medical Center Department of Internal Medicine
ÀÌ°æÈñ(Lee Kyung-Hee) - Yeungnam University College of Medicine Department of Internal Medicine
Á¤ÀçÈ£(Cheong Jae-Ho) - Yonsei University College of Medicine Department of Surgery
Çü¿ìÁø(Hyung Woo-Jin) - Yonsei University College of Medicine Department of Surgery
³ë¼ºÈÆ(Noh Sung-Hoon) - Yonsei University College of Medicine Department of Surgery
Á¤Çöö(Chung Hyun-Cheol) - Yonsei University College of Medicine Department of Internal Medicine
¶ó¼±¿µ(Rha Sun-Young) - Yonsei University College of Medicine Department of Internal Medicine
Abstract
Purpose: We conducted a randomized, multicenter, phase III trial to compare S-1 plus docetaxel (DS) with S-1 plus cisplatin (SP) as adjuvant chemotherapy for stage III gastric cancer patients.
Materials and Methods: Stage III gastric cancer patients who had received curative gastrectomy with D2 lymphadenectomy were randomized into equal groups to receive adjuvant chemotherapy of eight cycles of DS (S-1 70 mg/m2/day on days 1-14 plus docetaxel 35 mg/m2on days 1 and 8) every 3 weeks or SP (S-1 70 mg/m2/day on days 1-14 plus cisplatin 60 mg/m2on day 1) every 3 weeks. The primary endpoint was 3-year disease-free survival (DFS) rate.
Results: Between November 2010 and July 2013, 153 patients (75 patients to DS and 78 patients to SP) were enrolled from 8 institutions in Korea. After the capecitabine plus oxaliplatin was approved based on the CLASSIC study, itwas decided to close the study early. With a median follow-up duration of 56.9 months, the 3-year DFS rate between two groups was not significantly different (49.14% in DS group vs. 52.5% in SP group). The most common grade 3-4 adverse event was neutropenia (42.7% in DS and 38.5% in SP, p=0.351). SP group had more grade 3-4 anemia (1.3% vs. 11.5%, p=0.037), whereas grade 3-4 hand-foot syndrome (4.1% vs. 0%, p=0.025) and mucositis (10.7% vs. 2.6%, p=0.001) were more common in DS group. Fifty-one patients (68%) in DS group and 52 (66.7%) in SP group finished planned treatment.
Conclusion: Our findings suggest that SP or DS is an effective and tolerable option for patients with curatively resected stage III gastric cancer.
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Stomach neoplasms, Stage III, S-1 based doublet, Docetaxel, Cisplatin, Adjuvant chemotherapy
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The 3-year DFS rate between two groups was not significantly different (49.14% in DS group vs. 52.5% in SP group).