Objective To investigate the clinical efficacy of S-1 combined with cisplatin in the treatment of old patients with advanced gastric cancer.Methods 85 patients were randomly divided into two groups.Experimental group was treated by S-1 combined with cisplatin,while control group was treated by 5-FU and cisplatin.Short-term efficacy and adverse reactions were evaluated after four cycles.Results All patients had succcssfully accomplished chemotherapy.Compared with the control group ( RR =52.4％,DCR =81.0％ ),RR and DCR in experimental group ( RR =67.4％,DCR =93.0％ ) had statistically significant difference ( P ＜ 0.05 ).The top three of adverse reactions and complications in patients of the two groups were:nausea and vomiting,low WBC,low hemoglobin concentration.Compared with the control group,the toxicity in experimental group had no statistically significant difference ( P ＞0.05).All patients were followed up with a meau of( 15.5 - 2.7 ) months.The 1 year survival rate was 60.5％(26/43) in the experimental group; the 1 year survival rate was 52.4％ (21/42) in the control group.There was no statistically significant difference( P ＞ 0.05 ).Conclusion The S-1 combined with cisplatin had shown better efficacy in the treatment of old patients with advanced gastric carcinoma,and the toxicity was relatively mild and tolerable.