s-1-(combination) and Lacrimal-Duct-Obstruction

To identify predictive factors for ocular complications caused by the anticancer drug S-1.. A questionnaire was administered to 39 patients who underwent S-1 chemotherapy at Kobe City Medical Center General Hospital, with the aim to determine whether these patients were aware of the ocular complications caused by S-1. Cognition rate was determined. The 26 patients who requested opthalmological examination for further evaluation studied further and classified into two groups-those who had developed corneal epithelial complications, conjunctival injection or chemosis, or lacrimal duct blockages (referred to as the positive group) and those without these findings (referred to as the negative group). Predictive factors, such as age, sex, total administration days, total dose, presence or absence of anticancer drug pretreatment, and single-drug or combination-drug therapy, were investigated and compared between groups.. Of the 39 patients who completed the questionnaire, ten were aware of the potential for ocular complications due to S-1 chemotherapy (cognition rate 25.6 %). Of the 26 patients who had requested opthalmological examination and entered into the study, 13 (26 eyes) were classified into the positive group, with corneal complications observed in 15 eyes (57.7 %), conjunctivitis in 26 eyes (100 %), and lacrimal duct blockage in 14 eyes (53.8 %). Cognition rate in the 13 patients in the positive group and the 13 patients in the negative group was 38.5 % (5 patients) and 7.7 % (1 patient), respectively. Patient age was significantly different between the two groups, with the patients in the positive group being significantly older than those in the negative group (mean age ± standard deviation: 71.6 ± 6.8 vs. 63.5 ± 7.3 years, respectively; P = 0.0077, Student's t test). No other significant predictive factors were detected.. Older patients were at greater risk of S-1-related ocular complications, but these complications were not associated with total administration days or total dose.

Topics: Adult; Aged; Aged, 80 and over; Antimetabolites, Antineoplastic; Conjunctivitis; Corneal Diseases; Drug Combinations; Female; Health Knowledge, Attitudes, Practice; Humans; Japan; Lacrimal Duct Obstruction; Male; Middle Aged; Neoplasms; Oxonic Acid; Risk Factors; Surveys and Questionnaires; Tegafur

Topics: Antimetabolites, Antineoplastic; Conjunctivitis; Corneal Diseases; Drug Combinations; Epithelial Cells; Humans; Lacrimal Duct Obstruction; Neoplasms; Oxonic Acid; Tegafur

To report dacryoendoscopic observations and the incidence of lacrimal obstruction/stenosis associated with S-1, an oral anticancer drug.. Retrospective, nonrandomized clinical trial.. A total of 52 patients (41 men, 11 women; age 42-93 years) who were prescribed the anticancer drug S-1 were studied. Patients who suffered eye complaints following S-1 treatment underwent ophthalmic examination, probing and lacrimal irrigation. Patients whose tear meniscus was high or had abnormal lacrimal irrigation were evaluated by dacryoendoscopy.. Overall, 5 of 52 S-1-treated patients (9.6%) experienced lacrimal passage stenosis/obstruction. One patient had punctal stenosis, and four patients had canalicular obstruction/stenosis. The onset of epiphora ranged from 2 to 8 months (4.4 ± 2.2 months, mean ± SD) after the initiation of chemotherapy.. Patients receiving S-1 treatment should be evaluated for potential lacrimal disorders, particularly canalicular obstruction/stenosis. Dacryoendoscopic observation is effective for the diagnosis of this side effect.

Topics: Administration, Oral; Adult; Aged; Aged, 80 and over; Antimetabolites, Antineoplastic; Colonic Neoplasms; Drug Combinations; Endoscopy; Female; Humans; Incidence; Lacrimal Duct Obstruction; Lung Neoplasms; Male; Middle Aged; Nasolacrimal Duct; Oxonic Acid; Pancreatic Neoplasms; Retrospective Studies; Stomach Neoplasms; Tegafur

This study was conducted to determine the incidence and clinical characteristics of lacrimal drainage obstruction (LDO) in patients receiving S-1 chemotherapy.. Consecutive 170 patients with gastric cancer who underwent curative surgery and received adjuvant S-1 chemotherapy were enrolled. S-1 was administered orally (40 mg/m2 b.i.d. on days 1-28 every 6 weeks) for 1 year. Ophthalmologic examinations were carried out on patients complaining of epiphora.. Thirty-one patients (18%) developed epiphora. Among 31 patients, 25 underwent ophthalmologic examinations and 22 (88%) were diagnosed with LDO. The median time to the onset of LDO was 2.9 months. The most common site of obstruction was the nasolacrimal duct [86% (19/22)]; punctal [23% (5/22)] and canalicular obstruction [14% (3/22)] were also noted. In multivariate analysis, total gastrectomy [versus partial gastrectomy: hazard ratio (HR), 2.9; P=0.014] and creatinine clearance<50 ml/min (versus ≥50 ml/min: HR, 2.9; P=0.038) were independent risk factors for the development of LDO.. Considering the high incidence of LDO in patients receiving S-1 chemotherapy, oncologists should be alert to epiphora and cooperate with ophthalmologists in the early stages to improve the quality of life of patients and avoid more complicated ophthalmologic procedures.

Topics: Adult; Aged; Antimetabolites, Antineoplastic; Antineoplastic Combined Chemotherapy Protocols; Drug Combinations; Female; Humans; Lacrimal Duct Obstruction; Male; Middle Aged; Nasolacrimal Duct; Oxonic Acid; Stomach Neoplasms; Tegafur

S-1 is a new oral anticancer drug containing tegafur, which is a prodrug of 5-fluorouracil. In this report, we describe the clinical features of three patients who suffered corneal disorders that seemed to be caused by S-1 administration.. One female and two male patients, whose ages ranged from 57 to 69 years, were entered in this study. Between 3 to 14 months after they started oral S-1 therapy, they experienced sudden visual reduction. They all had corneal disorders, which occurred in the inferior and the superior areas, and progressed toward the center. As the corneal disorders invaded the pupil area, the patients noticed visual disturbance. They recovered their vision and their corneal disorders diminished when the drug was discontinued. However, after the drug intake was resumed, the corneal disorders occurred again in some cases. All patients also had lacrimal obstructions.. S-1 treated patients should be followed carefully for ophthalmic complications because corneal disorders are likely to appear.

Topics: Administration, Oral; Aged; Antimetabolites, Antineoplastic; Corneal Diseases; Drug Combinations; Female; Humans; Lacrimal Duct Obstruction; Male; Middle Aged; Oxonic Acid; Prodrugs; Tegafur

To report canalicular stenosis as a side effect of the new antineoplastic agent S-1.. Interventional case series.. Three patients who received S-1 for treatment of gastrointestinal cancer at a tertiary cancer center were evaluated and treated for epiphora.. Two patients were found to have severe canalicular stenosis and nasolacrimal duct blockage after approximately 6 months of S-1 therapy. One patient underwent dacryocystorhinostomy with silicone tube placement on one side and dacryocystorhinostomy and Pyrex glass tube placement on the other side. The other patient declined a surgical intervention. One additional patient with epiphora had punctal stenosis early in the course of S-1 therapy. His epiphora resolved after probing and irrigation and 4 weeks of topical corticosteroid therapy.. Canalicular and nasolacrimal duct blockage is a previously unreported side effect of S-1 and should be recognized and treated at its earliest possible stage so that complete closure of the canaliculi can be avoided.

Topics: Aged; Antimetabolites, Antineoplastic; Dacryocystorhinostomy; Drug Combinations; Female; Gastrointestinal Neoplasms; Humans; Intubation; Lacrimal Duct Obstruction; Male; Middle Aged; Nasolacrimal Duct; Oxonic Acid; Pyridines; Tegafur; Therapeutic Irrigation