Feasibility of adjuvant chemotherapy with S-1 consisting of a 4-week administration and a two-week rest period in patients with completely resected non-small cell lung cancer

Okumura,Shunsuke; Sasaki,Takaaki; Satoh,Kazuhiro; Kitada,Masahiro; Nagase,Atsushi; Yatsuyanagi,Eiji; Ohsaki,Yoshinobu

doi:10.3892/mco.2012.6

Feasibility of adjuvant chemotherapy with S-1 consisting of a 4-week administration and a two-week rest period in patients with completely resected non-small cell lung cancer

Authors:
- Shunsuke Okumura
- Takaaki Sasaki
- Kazuhiro Satoh
- Masahiro Kitada
- Atsushi Nagase
- Eiji Yatsuyanagi
- Yoshinobu Ohsaki
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Affiliations: Respiratory Center, Asahikawa Medical University, Asahikawa, Hokkaido 0788510, Japan, Department of Respiratory Surgery, National Hospital Organization, Asahikawa Medical Center, Asahikawa, Hokkaido 0708644, Japan, Department of Respiratory Surgery, National Hospital Organization, Obihiro Hospital, Obihiro, Hokkaido 0808518, Japan
Published online on: August 6, 2012 https://doi.org/10.3892/mco.2012.6
Pages: 124-130

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Abstract

The efficacy of adjuvant chemotherapy with S-1 in patients with completely resected non-small cell lung cancer (NSCLC) has yet to be clarified, and the appropriate schedule for the adjuvant chemotherapy with S-1 remains unknown. A phase II study was conducted to evaluate the feasibility and efficacy of adjuvant chemotherapy with S-1. Patients enrolled in this study were 20-75 years old, had pathological stage IB-IIIA NSCLC, and had received complete resection of NSCLC. S-1 (80 mg/m2) was administered orally to the patients for four weeks followed by a two-week rest period (conventional schedule), for a maximum of eight cycles. The primary endpoint was relative dose intensity (RDI), while the secondary endpoints were safety and 1 year of disease‑free survival (1y-DFS). Between May 2007 and October 2009, 28 patients were enrolled. The RDI was 63.1% (95% CI, 48.6-77.7). No grade 3 or worse hematological toxicity was observed. Grade 3 non-hematological toxicities were observed in four patients. No grade 4 or worse hematological toxicity was detected. The probability of 1y-DFS was 85.7% (95% CI, 72.8-98.6). In the subgroup analysis, the median RDI of patients over 65 years old was lower compared to the other patients (44.8 vs. 100%; P=0.013; Mann-Whitney U test). Creatinine clearance (CCr) was lower in the older group, with more grade 2 or 3 non-hematological toxicities in the elderly patients. These results suggest that the conventional schedule of adjuvant chemotherapy with S-1 is not likely to be feasible in older patients with completely resected NSCLC.

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