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Okumura N, Soh J, Suzuki H, Nakata M, Fujiwara T, Nakamura H, Sonobe M, Fujinaga T, Kataoka K, Gemba K, Kataoka M, Hotta K, Yoshioka H, Matsuo K, Sakamoto J, Date H, Toyooka S. Randomized phase II study of daily and alternate-day administration of S-1 for adjuvant chemotherapy in completely-resected stage I non-small cell lung cancer: results of the Setouchi Lung Cancer Group Study 1301. BMC Cancer 2021; 21:506. [PMID: 33957881 PMCID: PMC8101150 DOI: 10.1186/s12885-021-08232-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 04/21/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of this multicenter, randomized phase II study was to analyze the feasibility and safety of alternate-day S-1, an oral fluoropyrimidine, for adjuvant chemotherapy in patients with completely resected pathological stage I (tumor diameter > 2 cm) non-small cell lung cancer (NSCLC). METHODS Patients were randomly assigned to receive adjuvant chemotherapy for 1 year comprising either alternate-day oral administration of S-1 (80 mg/m2/day) for 4 days a week (Group A) or a 2-week oral administration of S-1 (80 mg/m2/day) followed by 1 week of rest (Group B). The primary endpoint was feasibility, which was defined as the proportion of patients who completed the allocated intervention for 6 months with a relative dose intensity (RDI) of 70% or more. RESULTS Ninety-three patients were enrolled of whom 90 patients received S-1 treatment. Median follow-up was 66.9 months. The treatment completion rate based on an RDI of 70% or more for 6 months was 84.4% (95%CI; 70.5-93.5%) in group A and 64.4% (95%CI; 48.8-78.1%) in group B. There were no grade 4 adverse events in either group. Moderate or severe adverse events (grade 2 or grade 3) were significantly more frequent in group B (67%) compared with group A (29%, P = 0.001). The 5-year relapse-free survival rate was 87.0 and 80.9% for group A and B, respectively (P = 0.451). The 5-year overall survival rate for all patients (n = 93) was 100 and 89.4% for group A and B, respectively (P = 0.136). CONCLUSION Alternate-day oral administration of S-1 for 1 year as adjuvant chemotherapy was demonstrated to be feasible with low toxicity in completely resected stage I (tumor diameter > 2 cm) NSCLC. TRIAL REGISTRATION Trial registration number: UMIN000011994 . Date of registration: 10/8/2013.
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Affiliation(s)
- Norihito Okumura
- Department of Thoracic Surgery, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, 710-8602, Japan.
| | - Junichi Soh
- Department of Surgery, Division of Thoracic Surgery, Kindai University Faculty of Medicine, 377-2 Ohno-Higashi, Osaka-, Sayama, Japan
| | - Hiroyuki Suzuki
- Department of Chest Surgery, Fukushima Medical University, 1 Hikarigaoka, Fukushima, Japan
| | - Masao Nakata
- Department of General Thoracic Surgery, Kawasaki Medical School, 577 Matsushima, Kurashiki, Japan
| | - Toshiya Fujiwara
- Depatment of Thoracic Surgery, Hiroshima City Hiroshima Citizens Hospital, 7-33 Moto-machi, Naka-ku, Hiroshima, Japan
| | - Hiroshige Nakamura
- Division of General Thoracic Surgery, Tottori University Hospital, 36-1, Nishi-cho, Yonago, Japan
| | - Makoto Sonobe
- Department of Thoracic Surgery, Kyoto University, 54 Shogoinkawara-cho, Sakyo-ku, Kyoto, Japan
| | - Takuji Fujinaga
- Department of General Thoracic Surgery, National Hospital Organization Nagara Medical Center, 1300-7 Nagara, Gifu, Japan
| | - Kazuhiko Kataoka
- Department of Thoracic Surgery, National Hospital Organization Iwakuni Clinical Center, 1-1-1 Atagomachi, Iwakuni, Japan
| | - Kenichi Gemba
- Department of Respiratory Medicine, Chugoku Central Hospital, 148-13 Kamiiwanari, Miyuki-cho, Fukuyama, Japan
| | - Masafumi Kataoka
- Department of Surgery, Okayama Saiseikai General Hospital, 1-17-18 Ifuku-cho, Kita-ku, Okayama, Japan
| | - Katsuyuki Hotta
- Center for Innovative Clinical Medicine, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, Japan
| | - Hiroshige Yoshioka
- Department of Thoracic Oncology, Kansai Medical University Hospital, 2-3-1 Shinmachi, Hirakata, Osaka, Japan
| | - Keitaro Matsuo
- Division of Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, 1-1 Kanokoden, Chikusa-ku, Nagoya, Japan
- Department of Preventive Medicine, Kyushu University Faculty of Medical Sciences, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Japan
| | - Junichi Sakamoto
- Tokai Central Hospital, 4-6-2 Sohara Higashijima-cho, Kakamigahara, Japan
| | - Hiroshi Date
- Department of Thoracic Surgery, Kyoto University, 54 Shogoinkawara-cho, Sakyo-ku, Kyoto, Japan
| | - Shinichi Toyooka
- Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Science, 2-5-1 Shikata-cho, Kita-ku, Okayama, Japan
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Tanaka H, Tabe C, Okumura F, Shiratori T, Ishioka Y, Itoga M, Taima K, Morimoto T, Kimura D, Tsushima T, Tasaka S. A pilot study of adjuvant chemotherapy with carboplatin and oral S-1 for patients with completely resected stage II to IIIA non-small cell lung cancer. Thorac Cancer 2020; 11:1633-1638. [PMID: 32351044 PMCID: PMC7262903 DOI: 10.1111/1759-7714.13444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Accepted: 04/03/2020] [Indexed: 12/02/2022] Open
Abstract
Background Adjuvant chemotherapy with platinum‐based regimens for completely resected early‐stage non‐small cell lung cancer (NSCLC) provides overall survival benefit in several clinical trials. Objectives We conducted this prospective study to evaluate the efficacy and safety of adjuvant chemotherapy with carboplatin and S‐1 for patients with completely resected stage II to IIIA NSCLC. Methods Patients with completely resected stage IIA to IIIA NSCLC were treated with four cycles of carboplatin with area under the concentration time curve of 5 mg/mL/min on day 1 plus S‐1 at 80–120 mg/bodyweight per day for two weeks, followed by one‐week rest as adjuvant chemotherapy. The primary endpoint was the completion rate of three cycles of the treatment. The secondary endpoints were safety and two‐year survival rate. Results A total of 19 patients were enrolled, until the study was terminated prematurely because of fatal pulmonary embolism in two patients. The median number of treatment cycles was three (range: 1–4). The completion rate of three cycles was 78.9% (95% confidence interval [CI]: 56.6–91.4%). Two‐year disease‐free survival rate was 57.8%. Grade 3 or 4 hematological toxicities included neutropenia (26.2%), anemia (5.2%), and thrombocytopenia (15.7%). Grade 3 or 4 nonhematological toxicities were anorexia (10.5%) and nausea (10.5%). Febrile neutropenia developed in 5.2%. In two patients (10.5%), grade five pulmonary embolism was observed, and the causal relationship with treatment could not be denied. Conclusions Carboplatin and oral S‐1 had modest survival benefit, but this regimen was not tolerable in an adjuvant setting because fatal pulmonary embolism occurred in two patients. Key points Carboplatin and oral S‐1 had modest survival benefit but this regimen was not tolerable. Fatal pulmonary embolism occurred in this regimen.
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Affiliation(s)
- Hisashi Tanaka
- Department of Respiratory Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Chiori Tabe
- Department of Respiratory Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Fumihiko Okumura
- Department of Respiratory Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Toshihiro Shiratori
- Department of Respiratory Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Yoshiko Ishioka
- Department of Respiratory Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Masamichi Itoga
- Department of Respiratory Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Kageaki Taima
- Department of Respiratory Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Takeshi Morimoto
- Department of Respiratory Medicine, Aomori Prefectural Central Hospital, Aomori, Japan
| | - Daisuke Kimura
- Department of Thoracic and Cardiovascular Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Takao Tsushima
- Department of Thoracic and Cardiovascular Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Sadatomo Tasaka
- Department of Respiratory Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
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Han L, Wei ZX, Lv YF, Jiang AY. Efficacy of carboplatin plus S-1 for the treatment of non-small cell lung cancer: A protocol for a systematic review of randomized controlled trial. Medicine (Baltimore) 2019; 98:e15099. [PMID: 30946371 PMCID: PMC6455708 DOI: 10.1097/md.0000000000015099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Non-small cell lung cancer (NSCLC) is the most common lung cancer. Numerous clinical studies have reported that the combination of carboplatin and S-1 (CS) can be used to treat NSCLC effectively. However, no systematic review has been conducted to assess its efficacy and safety for NSCLC. This systematic review aims to evaluate the efficacy and safety of CS for treatment of patients with NSCLC. METHODS This study will retrieve the following electronic databases from inception to the February 1, 2019: Cochrane Library, EMBASE, MEDILINE, CINAHL, AMED, and 4 Chinese databases without any language limitations. This systematic review will include randomized controlled trials (RCTs) and case-control studies for assessing the efficacy and safety of CS for the treatment of NSCLC. Cochrane risk of bias will be used as methodological quality assessment for each qualified study. The RevMan V.5.3 software will be utilized to synthesize the data and conduct the meta-analysis if it is allowed. The data will be pooled by using the random-effects model or fixed-effects model. RESULTS The primary outcome is overall response rate. The secondary outcomes are overall survival, progression-free survival, the disease control rate, and any adverse events. CONCLUSION It will provide latest evidence to determine the efficacy and safety of CS for treatment of patients with NSCLC. ETHICS AND DISSEMINATION No research ethic approval is needed in this study because this study will not analyze individual patient data. The results are expected to disseminate through peer-reviewed journals. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42019124860.
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Affiliation(s)
- Lei Han
- Department of Respiratory Medicine, The Affiliated Hongqi Hospital of Mudanjiang Medical University, Mudanjiang
| | - Zhou-Xia Wei
- Department of General Medicine, The First Hospital of Jilin University, Changchun, China
| | - Yu-Feng Lv
- Department of Respiratory Medicine, The Affiliated Hongqi Hospital of Mudanjiang Medical University, Mudanjiang
| | - Ai-Ying Jiang
- Department of Respiratory Medicine, The Affiliated Hongqi Hospital of Mudanjiang Medical University, Mudanjiang
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Zhao D, Feng JF, Wang XH. A retrospective study of concurrent radiotherapy plus S-1 for treating advanced non-small cell lung cancer. Medicine (Baltimore) 2018; 97:e10740. [PMID: 29851779 PMCID: PMC6392540 DOI: 10.1097/md.0000000000010740] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
We investigated the efficacy of concurrent radiotherapy plus S-1 (CRS) for treating unresectable stage III advanced non-small-cell lung cancer (ANSCLC).Seventy five ANSCLC patients were included in this retrospective study. Of those, 40 patients were assigned to an intervention group, and received S-1 (orally at 40 mg/m) twice daily for 14 consecutive days. Then, concurrent radiotherapy was administered in 2 Gy fractions, 5 times weekly for a total dose of 60 Gy. The other 35 patients were assigned to a control group, and underwent concurrent radiotherapy (the same as the intervention group) and cisplatin (60 mg/m on day 1 (CRC). The outcome measurements included overall response rate (ORR), overall survival (OS), progression-free survival (PFS), and toxicity.The 3-year ORR was 60.7% and 43.9% for intervention group and control group, respectively (P = .031). The median OS was 34.1 months and 25.3 months in the intervention and control groups, respectively (P = .041). The median PFS was 31.5 months for intervention group, while it was 22.4 months for control group (P = .048). No significant difference in toxicity was found between the 2 groups.The results demonstrated that the efficacy of CRS was superior to the CRC in ANSCLC patients with similar toxicity.
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Affiliation(s)
- Dejun Zhao
- Department of Respiratory Medicine, The People's Hospital of Fuyang
| | - Jun-fei Feng
- Department of Respiratory Medicine, Hangzhou Fuyang Hospital of Traditional Chinese Medicine, Hangzhou, China
| | - Xue-hui Wang
- Department of Respiratory Medicine, First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
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Gu H, Wang X, Wu J, Fan RT, Shi YG. Therapeutic effects of re-radiotherapy combined with S-1 in treatment of recurrent esophageal carcinoma. Shijie Huaren Xiaohua Zazhi 2014; 22:3286-3290. [DOI: 10.11569/wcjd.v22.i22.3286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate the efficacy and safety of S-1 combined with three dimensional conformal radiotherapy in the treatment of recurrent esophageal carcinoma after radiotherapy.
METHODS: Sixty-one esophageal carcinoma patients who recurred after they had received radical radiotherapy and were confirmed by pathology were divided into either a study group or a control group according to whether receiving S-1 or not. All patients received three dimensional conformal radiotherapy at 1.8-2.0 Gy each time, 5 fractions a week to a total dose of 45-55 Gy. The patients in the study group received S-1 at a dose of 60 mg/(m2•d) for 14 days, every 3 weeks, totally 6 wk when they started receiving re-radiotherapy. The control group merely received re-radiotherapy.
RESULTS: The complete response rate was 38.7% in the study group, and 26.7% in the control group (P > 0.05). The effective rate was 74.2% in the study group, and 46.7% in the control group (P < 0.05). The 1-, 2- and 3-year survival rates were 54.8%, 38.7% and 16.1% in the study group, and 43.3%, 20.0% and 6.7% in the control group (P < 0.05).
CONCLUSION: For recurrent esophageal carcinoma after radical radiotherapy, S-1 combined with three dimensional conformal radiotherapy can improve the efficacy and prolong survival period without a significant increase in acute adverse effects of radiotherapy.
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