TS-1 as first-line therapy for gastric linitis plastica: historical control study

Area of Science:

• Oncology
• Gastroenterology
• Pharmacology

Background:

• Gastric linitis plastica (LP) is an advanced gastric cancer with a poor prognosis.
• Effective chemotherapy options for gastric LP have been limited.
• TS-1 has shown promise in treating advanced gastric cancers.

Purpose of the Study:

• To retrospectively compare the anti-tumor effects and survival outcomes of TS-1-based chemotherapy versus conventional chemotherapy in patients with unresectable gastric LP.
• To evaluate the efficacy and safety of TS-1 as a first-line therapy for gastric LP.

Main Methods:

• Retrospective analysis of 62 patients with unresectable gastric LP treated between November 1995 and December 2002.
• Patients were divided into two groups: TS-1 group (n=19) receiving TS-1 as first-line therapy, and non-TS-1 group (n=43) receiving conventional chemotherapy (5-fluorouracil, cisplatin, methotrexate, mitomycin C).
• Comparison of overall response rates, median survival times, and incidence of severe neutropenia and febrile neutropenia.

Main Results:

• The overall response rate in the TS-1 group (57.9%) was significantly higher than in the non-TS-1 group (27.9%) (P < 0.01).
• Median survival time was significantly longer in the TS-1 group (402 days) compared to the non-TS-1 group (213 days) (P < 0.01).
• Incidence of grade 3 or higher neutropenia and febrile neutropenia was lower in the TS-1 group (21.1% and 5.2%) compared to the non-TS-1 group (37.2% and 20.9%).

Conclusions:

• Chemotherapy including TS-1 demonstrates significantly greater anti-tumor effects and leads to longer survival times for gastric LP patients compared to conventional chemotherapy.
• TS-1 is a more effective and potentially safer first-line treatment option for unresectable gastric linitis plastica.
• Further prospective studies are warranted to confirm these findings.