Japan Gastric Cancer Association guideline states that S-1 alone could be considered for patient who is not suitable for S-1 plus cisplatin therapy . Previous studies showed S-1 monotherapy could be a reasonable option in the treatment of elderly patients. In our study, the ORR, PFS, OS were sound for patients of age >70 (47.1%, 6.00, 11.40 m) without difference compared with those of age ≤70 (36.4%, 4.00, 11.20 m) and seemed better than previously reported S-1 monotherapy (ORR 14.3–26.3%) and UFT/LV (ORR 22%) for elderly AGC patients [28–30]. The oral convenience makes the S-1/LV regimen extremely useful clinically, especially for elderly patients.