s-1-(combination) and Diabetes-Mellitus

The aim of this study was to clarify the impact of diabetes mellitus (DM) as well as antidiabetic, antihypertensive, and antihyperlipidemic medications such as metformin and statins on survival in patients with advanced pancreatic cancer receiving chemotherapy.. We retrospectively reviewed the medical records of 250 patients with advanced pancreatic cancer receiving chemotherapy. Multivariate analyses of prognostic factors for survival were performed both in overall population and in subgroups with and without DM.. Diabetes mellitus was diagnosed in 124 patients (50%) who had less distant metastasis and more hypertension. Thirty patients received statin for hyperlipidemia. Overall survival was 13.3 versus 10.0 months with and without DM (P = 0.084), but hazard ratio of DM was 1.05 (P = 0.758) in the multivariate analysis. Subgroup analysis of diabetic patients, but not in non-diabetic patients, demonstrated use of statins (hazard ratio, 0.40; P = 0.010) as a prognostic factor, as well as distant metastasis, performance status, combination therapy with gemcitabine and S-1, and use of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers. No antidiabetic medications were prognostic factors.. Neither DM nor antidiabetic treatment had prognostic impact on advanced pancreatic cancer. Statin use was associated with better survival in the diabetic patients.

Topics: Adult; Aged; Aged, 80 and over; Antihypertensive Agents; Antineoplastic Combined Chemotherapy Protocols; Chi-Square Distribution; Comorbidity; Deoxycytidine; Diabetes Mellitus; Disease-Free Survival; Drug Combinations; Female; Gemcitabine; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Hyperlipidemias; Hypertension; Hypoglycemic Agents; Japan; Kaplan-Meier Estimate; Male; Middle Aged; Multivariate Analysis; Oxonic Acid; Pancreatic Neoplasms; Retrospective Studies; Risk Factors; Tegafur; Time Factors; Treatment Outcome

Small cell carcinoma of the esophagus (SmCCE) is a rare disease which is considered to be more malignant than the most common types of esophageal cancer. The optimal treatment strategy for this disease still remains controversial. A 69-year-old male was diagnosed to have SmCCE (stage IIIA, T3N1M0). Due to the patient's poor general condition, chemo-radiotherapy consisting of S-1/cisplatin therapy and a total of 60 Gy of radiotherapy was performed. After the treatment, the main lesion completely disappeared while some ulceration remained. A histological examination revealed no viable cancer cells in biopsy specimens obtained by endoscopy. Computed tomographic examinations showed a decreased wall thickness of the esophagus and an improvement in the swelling of the lymph nodes. S-1 monotherapy was administered following the main chemoradiation therapy, and it was performed for a total of 20 courses. The patient has been doing well without recurrence for over 3 years. We judged the effect to be a complete response. This combination chemo-radiotherapy with S-1 and cisplatin may therefore be one of the effective treatments against SmCCE.

Topics: Aged; Antineoplastic Combined Chemotherapy Protocols; Asthma; Carcinoma, Small Cell; Cisplatin; Combined Modality Therapy; Diabetes Mellitus; Drug Combinations; Esophageal Neoplasms; Humans; Hypertension; Male; Neoplasm Staging; Oxonic Acid; Radiotherapy; Remission Induction; Tegafur