s-1-(combination) and Cerebral-Infarction

A case showing reinforcement of the action of warfarin and potassium in a patient administered S-1 is reported.The patient was a 71-year-old man with left upper gingival cancer.He had ventricular tachycardia (VT), hypertrophic cardiomyopathy, and a cerebellar infarction.He underwent a pacemaker implantation, and was administered warfarin.After the operation, in mid-March 2010, he was administered with S-1 and warfarin. However, the international normalized ratio of prothrombin time (PT-INR) increased to an extremely high level of 5.82, and S-1 and warfarin were stopped. They were re-administered at the end of April, and the PT-INR stabilized to approximately 2.

Topics: Aged; Anticoagulants; Antimetabolites, Antineoplastic; Cardiomyopathy, Hypertrophic; Cerebral Infarction; Drug Combinations; Drug Interactions; Humans; Male; Mouth Neoplasms; Neoplasms, Squamous Cell; Oxonic Acid; Tachycardia, Ventricular; Tegafur; Warfarin

The purpose of this study was to evaluate the effectiveness and adverse events of combination chemotherapy with oral S-1 administration following docetaxel (DOC) treatment by superselective intra-arterial infusion as neo-adjuvant chemotherapy (NAC) for patients with oral squamous cell carcinoma. Thirteen patients were enrolled in this study (9 men and 4 women, with a mean age of 61. 0 years). All patients were given S-1 65mg/m(2) per day for 14 days, and DOC 40-50mg/m(2) by intraarterial infusion was administered. The locoregional response evaluated 3 weeks after administration was 100%, including a 69. 2% complete response. According to Oboshi and Shimosato's classification, histological evaluation of surgical specimens revealed that 3 cases were Grade II a, 4 cases Grade II b, 1 case Grade IV a, and 4 cases Grade IV c. The severe side effects were neutropenia and cerebral infarction. The present study suggests that combination chemotherapy with S-1 and DOC by superselective intra-arterial infusion would be an effective and safe regimen in NAC for oral squamous cell carcinomas.

Topics: Administration, Oral; Adult; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols; Carcinoma, Squamous Cell; Cerebral Infarction; Docetaxel; Drug Combinations; Female; Humans; Infusions, Intra-Arterial; Male; Middle Aged; Mouth Neoplasms; Neoplasm Staging; Neutropenia; Oxonic Acid; Taxoids; Tegafur

A 72-year-old male with gastric cancer was referred to our hospital. The patient had been administered warfarin for cerebral infarction, aspirin and clopidogrel sulfate after percutaneous coronary intervention (PCI). Distal gastrectomy was performed for the lesion after discontinuing these drugs. After operation, warfarin was administered again as soon as possible, and on the other hand, we started treating the patient with S-1 for adjuvant chemotherapy carefully, because the interaction of each drug had been described before. On the sixth day after starting S-1, we reduced the amount of warfarin because PT-INR was elevated to a extremely high level of 6.84. Seven days later, PT-INR recovered to a slightly high level of 2.17. With continuation of S-1, PT-INR showed large fluctuations, so we needed to regulate the amount of warfarin carefully. It is important that we recognize the possibility of immediate interaction of two drugs and, before these drugs are administered, inform the patient about it.

Topics: Aged; Anticoagulants; Antimetabolites, Antineoplastic; Cerebral Infarction; Chemotherapy, Adjuvant; Drug Combinations; Gastrectomy; Humans; Male; Oxonic Acid; Stomach Neoplasms; Tegafur; Warfarin

We report a 29-year-old woman with gastric cancer who developed Trousseau's syndrome, a malignancy-related thromboembolism, during chemotherapy. She was diagnosed with a mucin-producing adenocarcinoma of the stomach, and chemotherapy with S-1 and cisplatin was commenced. During treatment, she developed a sudden onset of right hemiplegia. Magnetic resonance imaging showed an acute cerebral infarction of the left cerebral hemisphere. The underlying pathophysiology is thought to be chronic disseminated intravascular coagulation due to mucin-producing adenocarcinomas. However, cisplatin-induced vascular toxicity and hypercoagulability caused by decreased plasma protein C activity, elevated plasma von-Willebrand factor levels, and hypomagnesemia has also been proposed to be associated with thrombogenicity.

Topics: Acute Disease; Adult; Antineoplastic Combined Chemotherapy Protocols; Carcinoma, Signet Ring Cell; Cerebral Infarction; Cisplatin; Drug Combinations; Fatal Outcome; Female; Humans; Oxonic Acid; Stomach Neoplasms; Tegafur; Thromboembolism