A feasibility study of outpatient chemotherapy with S-1 + cisplatin in patients with advanced gastric cancer
Regimens of standard-dose cisplatin have usually been administered as inpatient chemotherapy in Japan. This prospective study evaluated the feasibility of outpatient chemotherapy with standard-dose cisplatin in Japanese patients with advanced gastric cancer. Advanced gastric cancer patients received an S-1 + cisplatin regimen (S-1: 80–120 mg days 1–21; cisplatin: 60 mg/m2 day 8, every 4–5 weeks), either as outpatient chemotherapy with oral hydration on days 9–10, or as inpatient chemotherapy with intravenous hydration on days 9–10, based on the results of an oral hydration test during days 1–7 of the first cycle. The primary endpoint was the completion rate of two cycles in the outpatient group. A total of 36 patients were enrolled: 32 were allocated to the outpatient group and 4 to the inpatient group. The completion rate of two cycles in the outpatient group was 78% [90% confidence interval (CI): 63–89]. The median of the total number of treatment cycles of S-1 + cisplatin and the median progression-free survival in the outpatient group were 5 (range 1–11) and 10.6 months (95% CI 4.2–16.9), respectively. Although seven patients in the outpatient group discontinued treatment, mainly owing to gastrointestinal toxicity, most of them could continue S-1 + cisplatin by switching to inpatient chemotherapy from the next cycle. Outpatient chemotherapy with S-1 + cisplatin in advanced gastric cancer patients can be safely and effectively administered in Japan with appropriate patient selection and supportive treatment.