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Japanese Journal of Clinical Oncology Advance Access published online on November 6, 2008
Japanese Journal of Clinical Oncology, doi:10.1093/jjco/hyn109
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© The Author (2008). Published by Oxford University Press. All rights reserved

Irinotecan Plus Cisplatin Therapy and S-1 Plus Cisplatin Therapy for Advanced or Recurrent Gastric Cancer in a Single Institution

Koji Nakashima, Shuichi Hironaka, Narikazu Boku, Yusuke Onozawa, Akira Fukutomi, Kentaro Yamazaki, Hirofumi Yasui, Keisei Taku, Takashi Kojima and Nozomu Machida

Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Sunto-gun, Shizuoka, Japan

For reprints and all correspondence: Shuichi Hironaka, Division of Gastrointestinal Oncology, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi Sunto-gun, Shizuoka 411-8777, Japan. E-mail: s.hironaka{at}scchr.jp

Received June 5, 2008; accepted September 15, 2008

Background: From the results of the JCOG9912 and SPIRITS trials, S-1 plus cisplatin (CDDP) therapy (SP) has been recognized as the standard chemotherapy for advanced gastric cancer in Japan. However, in their subsets of patients with the target lesion, irinotecan (CPT-11) plus CDDP therapy (IP) resulted in longer survival than 5-fluorouracil alone while SP exhibited a survival similar to S-1 alone. The objective of this study was to clarify the safety and efficacy of these two regimens.

Methods: Forty-four patients were treated with IP and 32 with SP between September 2002 and July 2006 at Shizuoka Cancer Center. In IP, 70 mg/m2 CPT-11 was administered on Days 1 and 15, 80 mg/m2 CDDP on Day 1, repeated every 4 weeks. In SP, 40–60 mg S-1 depending on the patient’s body surface area was given orally twice daily for 21 days and 60 mg/m2 CDDP intravenously on Day 8, repeated every 5 weeks.

Results: The response rate, progression-free survival and median survival were 47% (17 of 36), 170 and 444 days in IP, and 80% (21 of 26), 235 and 469 days in SP. In patients with target lesions, those were 47%, 170 and 431 days in IP, and 80%, 235 and 442 days in SP. The incidence of Grade 3 or 4 toxicity was similar in both groups, but patient refusal of treatment was more frequent for IP than for SP.

Conclusions: Our results demonstrate a better efficacy and feasibility of SP than IP for advanced gastric cancer patients, with or without a target lesion.

Key Words: gastric cancer • irinotecan • cisplatin • S-1


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