First-line chemotherapy with S-1 alone or S-1 plus cisplatin for elderly patients with advanced gastric cancer

a multicenter propensity score matched study

Akitaka Makiyama, Kenji Kunieda, Masaaki Noguchi, Takeshi Kajiwara, Takao Tamura, Koji Takeda, Junko Sugiyama, Keiko Minashi, Toshikazu Moriwaki, Naotoshi Sugimoto, Michitaka Nagase, Yuji Negoro, Takashi Tsuda, Hideki Shimodaira, Naohiro Okano, Akihito Tsuji, Daisuke Sakai, Kazuhiro Yanagihara, Shinya Ueda, Shingo Tamura & 15 others Satoshi Otsu, Takuya Honda, Yuzo Matsushita, Tatsuya Okuno, Tomomi Kashiwada, Akira Nozaki, Masahide Ebi, Hiroyuki Okuda, Mototsugu Shimokawa, Shuichi Hironaka, Ichinosuke Hyodo, Eishi Baba, Narikazu Boku, Kei Muro, Taito Esaki

研究成果: ジャーナルへの寄稿記事

1 引用 (Scopus)

抄録

Background: Fluoropyrimidine and platinum combination is the standard treatment for advanced or recurrent gastric cancer (AGC). However, fluoropyrimidine monotherapy is commonly used for elderly patients with AGC because of its good tolerability. Methods: In this multicenter retrospective study, we collected clinical data of AGC patients aged 70 years or older, treated with S-1 alone or S-1 plus cisplatin (SP) as the first-line treatment between January 2009 and December 2011. Propensity score matched cohorts (PSMC) were used for reducing the confounding effects to compare efficacy and safety between the two treatment groups. Cox regression analysis was performed to clarify the prognostic factors. Results: PSMC (n = 109 in each group) were selected from among 444 eligible patients (S-1 group, 210; SP group, 234); the S-1 group included more patients deemed unfit for intensive chemotherapy than the SP group (e.g., higher age, poorer PS, poor renal function). In the PSMC, patients’ characteristics were comparable between groups, except the male ratio (S-1 group, 64.2%; SP group, 77.1%; p = 0.04). No significant differences were observed in either overall survival [hazard ratio (HR) 0.93, p = 0.63] or progression-free survival (HR 1.09, p = 0.61). Severe adverse events (AEs) and hospitalization due to AEs were more frequent in the SP group than in the S-1 group (p < 0.001 each). Conclusion: Our findings do not support the survival benefit of SP over S-1 in elderly patients with AGC. We are now conducting a prospective comparative study to optimize treatment strategy and explore applicability of the geriatric assessment for these patients.

元の言語英語
ページ(範囲)792-801
ページ数10
ジャーナルGastric Cancer
21
発行部数5
DOI
出版物ステータス出版済み - 9 1 2018

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Propensity Score
Cisplatin
Stomach Neoplasms
Drug Therapy
Geriatric Assessment
Survival
Therapeutics
Platinum
Multicenter Studies
Disease-Free Survival
Hospitalization
Retrospective Studies
Regression Analysis
Prospective Studies
Kidney
Safety

All Science Journal Classification (ASJC) codes

  • Oncology
  • Gastroenterology
  • Cancer Research

これを引用

First-line chemotherapy with S-1 alone or S-1 plus cisplatin for elderly patients with advanced gastric cancer : a multicenter propensity score matched study. / Makiyama, Akitaka; Kunieda, Kenji; Noguchi, Masaaki; Kajiwara, Takeshi; Tamura, Takao; Takeda, Koji; Sugiyama, Junko; Minashi, Keiko; Moriwaki, Toshikazu; Sugimoto, Naotoshi; Nagase, Michitaka; Negoro, Yuji; Tsuda, Takashi; Shimodaira, Hideki; Okano, Naohiro; Tsuji, Akihito; Sakai, Daisuke; Yanagihara, Kazuhiro; Ueda, Shinya; Tamura, Shingo; Otsu, Satoshi; Honda, Takuya; Matsushita, Yuzo; Okuno, Tatsuya; Kashiwada, Tomomi; Nozaki, Akira; Ebi, Masahide; Okuda, Hiroyuki; Shimokawa, Mototsugu; Hironaka, Shuichi; Hyodo, Ichinosuke; Baba, Eishi; Boku, Narikazu; Muro, Kei; Esaki, Taito.

:: Gastric Cancer, 巻 21, 番号 5, 01.09.2018, p. 792-801.

研究成果: ジャーナルへの寄稿記事

Makiyama, A, Kunieda, K, Noguchi, M, Kajiwara, T, Tamura, T, Takeda, K, Sugiyama, J, Minashi, K, Moriwaki, T, Sugimoto, N, Nagase, M, Negoro, Y, Tsuda, T, Shimodaira, H, Okano, N, Tsuji, A, Sakai, D, Yanagihara, K, Ueda, S, Tamura, S, Otsu, S, Honda, T, Matsushita, Y, Okuno, T, Kashiwada, T, Nozaki, A, Ebi, M, Okuda, H, Shimokawa, M, Hironaka, S, Hyodo, I, Baba, E, Boku, N, Muro, K & Esaki, T 2018, 'First-line chemotherapy with S-1 alone or S-1 plus cisplatin for elderly patients with advanced gastric cancer: a multicenter propensity score matched study', Gastric Cancer, 巻. 21, 番号 5, pp. 792-801. https://doi.org/10.1007/s10120-018-0797-y
Makiyama, Akitaka ; Kunieda, Kenji ; Noguchi, Masaaki ; Kajiwara, Takeshi ; Tamura, Takao ; Takeda, Koji ; Sugiyama, Junko ; Minashi, Keiko ; Moriwaki, Toshikazu ; Sugimoto, Naotoshi ; Nagase, Michitaka ; Negoro, Yuji ; Tsuda, Takashi ; Shimodaira, Hideki ; Okano, Naohiro ; Tsuji, Akihito ; Sakai, Daisuke ; Yanagihara, Kazuhiro ; Ueda, Shinya ; Tamura, Shingo ; Otsu, Satoshi ; Honda, Takuya ; Matsushita, Yuzo ; Okuno, Tatsuya ; Kashiwada, Tomomi ; Nozaki, Akira ; Ebi, Masahide ; Okuda, Hiroyuki ; Shimokawa, Mototsugu ; Hironaka, Shuichi ; Hyodo, Ichinosuke ; Baba, Eishi ; Boku, Narikazu ; Muro, Kei ; Esaki, Taito. / First-line chemotherapy with S-1 alone or S-1 plus cisplatin for elderly patients with advanced gastric cancer : a multicenter propensity score matched study. :: Gastric Cancer. 2018 ; 巻 21, 番号 5. pp. 792-801.
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title = "First-line chemotherapy with S-1 alone or S-1 plus cisplatin for elderly patients with advanced gastric cancer: a multicenter propensity score matched study",
abstract = "Background: Fluoropyrimidine and platinum combination is the standard treatment for advanced or recurrent gastric cancer (AGC). However, fluoropyrimidine monotherapy is commonly used for elderly patients with AGC because of its good tolerability. Methods: In this multicenter retrospective study, we collected clinical data of AGC patients aged 70 years or older, treated with S-1 alone or S-1 plus cisplatin (SP) as the first-line treatment between January 2009 and December 2011. Propensity score matched cohorts (PSMC) were used for reducing the confounding effects to compare efficacy and safety between the two treatment groups. Cox regression analysis was performed to clarify the prognostic factors. Results: PSMC (n = 109 in each group) were selected from among 444 eligible patients (S-1 group, 210; SP group, 234); the S-1 group included more patients deemed unfit for intensive chemotherapy than the SP group (e.g., higher age, poorer PS, poor renal function). In the PSMC, patients’ characteristics were comparable between groups, except the male ratio (S-1 group, 64.2{\%}; SP group, 77.1{\%}; p = 0.04). No significant differences were observed in either overall survival [hazard ratio (HR) 0.93, p = 0.63] or progression-free survival (HR 1.09, p = 0.61). Severe adverse events (AEs) and hospitalization due to AEs were more frequent in the SP group than in the S-1 group (p < 0.001 each). Conclusion: Our findings do not support the survival benefit of SP over S-1 in elderly patients with AGC. We are now conducting a prospective comparative study to optimize treatment strategy and explore applicability of the geriatric assessment for these patients.",
author = "Akitaka Makiyama and Kenji Kunieda and Masaaki Noguchi and Takeshi Kajiwara and Takao Tamura and Koji Takeda and Junko Sugiyama and Keiko Minashi and Toshikazu Moriwaki and Naotoshi Sugimoto and Michitaka Nagase and Yuji Negoro and Takashi Tsuda and Hideki Shimodaira and Naohiro Okano and Akihito Tsuji and Daisuke Sakai and Kazuhiro Yanagihara and Shinya Ueda and Shingo Tamura and Satoshi Otsu and Takuya Honda and Yuzo Matsushita and Tatsuya Okuno and Tomomi Kashiwada and Akira Nozaki and Masahide Ebi and Hiroyuki Okuda and Mototsugu Shimokawa and Shuichi Hironaka and Ichinosuke Hyodo and Eishi Baba and Narikazu Boku and Kei Muro and Taito Esaki",
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month = "9",
day = "1",
doi = "10.1007/s10120-018-0797-y",
language = "English",
volume = "21",
pages = "792--801",
journal = "Gastric Cancer",
issn = "1436-3291",
publisher = "Springer Japan",
number = "5",

}

TY - JOUR

T1 - First-line chemotherapy with S-1 alone or S-1 plus cisplatin for elderly patients with advanced gastric cancer

T2 - a multicenter propensity score matched study

AU - Makiyama, Akitaka

AU - Kunieda, Kenji

AU - Noguchi, Masaaki

AU - Kajiwara, Takeshi

AU - Tamura, Takao

AU - Takeda, Koji

AU - Sugiyama, Junko

AU - Minashi, Keiko

AU - Moriwaki, Toshikazu

AU - Sugimoto, Naotoshi

AU - Nagase, Michitaka

AU - Negoro, Yuji

AU - Tsuda, Takashi

AU - Shimodaira, Hideki

AU - Okano, Naohiro

AU - Tsuji, Akihito

AU - Sakai, Daisuke

AU - Yanagihara, Kazuhiro

AU - Ueda, Shinya

AU - Tamura, Shingo

AU - Otsu, Satoshi

AU - Honda, Takuya

AU - Matsushita, Yuzo

AU - Okuno, Tatsuya

AU - Kashiwada, Tomomi

AU - Nozaki, Akira

AU - Ebi, Masahide

AU - Okuda, Hiroyuki

AU - Shimokawa, Mototsugu

AU - Hironaka, Shuichi

AU - Hyodo, Ichinosuke

AU - Baba, Eishi

AU - Boku, Narikazu

AU - Muro, Kei

AU - Esaki, Taito

PY - 2018/9/1

Y1 - 2018/9/1

N2 - Background: Fluoropyrimidine and platinum combination is the standard treatment for advanced or recurrent gastric cancer (AGC). However, fluoropyrimidine monotherapy is commonly used for elderly patients with AGC because of its good tolerability. Methods: In this multicenter retrospective study, we collected clinical data of AGC patients aged 70 years or older, treated with S-1 alone or S-1 plus cisplatin (SP) as the first-line treatment between January 2009 and December 2011. Propensity score matched cohorts (PSMC) were used for reducing the confounding effects to compare efficacy and safety between the two treatment groups. Cox regression analysis was performed to clarify the prognostic factors. Results: PSMC (n = 109 in each group) were selected from among 444 eligible patients (S-1 group, 210; SP group, 234); the S-1 group included more patients deemed unfit for intensive chemotherapy than the SP group (e.g., higher age, poorer PS, poor renal function). In the PSMC, patients’ characteristics were comparable between groups, except the male ratio (S-1 group, 64.2%; SP group, 77.1%; p = 0.04). No significant differences were observed in either overall survival [hazard ratio (HR) 0.93, p = 0.63] or progression-free survival (HR 1.09, p = 0.61). Severe adverse events (AEs) and hospitalization due to AEs were more frequent in the SP group than in the S-1 group (p < 0.001 each). Conclusion: Our findings do not support the survival benefit of SP over S-1 in elderly patients with AGC. We are now conducting a prospective comparative study to optimize treatment strategy and explore applicability of the geriatric assessment for these patients.

AB - Background: Fluoropyrimidine and platinum combination is the standard treatment for advanced or recurrent gastric cancer (AGC). However, fluoropyrimidine monotherapy is commonly used for elderly patients with AGC because of its good tolerability. Methods: In this multicenter retrospective study, we collected clinical data of AGC patients aged 70 years or older, treated with S-1 alone or S-1 plus cisplatin (SP) as the first-line treatment between January 2009 and December 2011. Propensity score matched cohorts (PSMC) were used for reducing the confounding effects to compare efficacy and safety between the two treatment groups. Cox regression analysis was performed to clarify the prognostic factors. Results: PSMC (n = 109 in each group) were selected from among 444 eligible patients (S-1 group, 210; SP group, 234); the S-1 group included more patients deemed unfit for intensive chemotherapy than the SP group (e.g., higher age, poorer PS, poor renal function). In the PSMC, patients’ characteristics were comparable between groups, except the male ratio (S-1 group, 64.2%; SP group, 77.1%; p = 0.04). No significant differences were observed in either overall survival [hazard ratio (HR) 0.93, p = 0.63] or progression-free survival (HR 1.09, p = 0.61). Severe adverse events (AEs) and hospitalization due to AEs were more frequent in the SP group than in the S-1 group (p < 0.001 each). Conclusion: Our findings do not support the survival benefit of SP over S-1 in elderly patients with AGC. We are now conducting a prospective comparative study to optimize treatment strategy and explore applicability of the geriatric assessment for these patients.

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U2 - 10.1007/s10120-018-0797-y

DO - 10.1007/s10120-018-0797-y

M3 - Article

VL - 21

SP - 792

EP - 801

JO - Gastric Cancer

JF - Gastric Cancer

SN - 1436-3291

IS - 5

ER -