s-1-(combination) and nedaplatin

A 7 4-year-old male was referred to our hospital for an abnormal chest shadow pointed out by a medical examination. A chest computed tomography revealed a tumor shadow 39 X 32mm in size in his left upper lobe in January, 2010. Pathological examination of biopsy specimens showed squamous cell carcinoma of the lung. Although there was no distant metastasis, multiple metastases to mediastinal lymph nodes was noted. He was diagnosed as Stage III A(cT2aN2M0). Considering his age and the histology of the disease, systemic chemotherapy with nedaplatin and S-1 was performed. The diameter of the primary lesion was decreased from 39mm to 18mm after 4 courses of chemotherapy, and was considered as partial response (PR)according to the RECIST criteria. The adverse events were grade 2 appetite loss, grade 3 neutropenia, and grade 2 thrombocytopenia. Recently, various new agents for treating non-squamous cell lung carcinoma have been developed, but there has been little progress in the treatment of squamous cell lung carcinoma. We experienced a patient with advanced squamous cell lung carcinoma who responded with CDGP/S-1 combination chemotherapy. We are now conducting a phase I / II clinical study to verify the usefulness of this regimen against advanced squamous cell lung carcinoma.

Topics: Aged; Antineoplastic Combined Chemotherapy Protocols; Carcinoma, Squamous Cell; Drug Combinations; Humans; Lung Neoplasms; Male; Neoplasm Staging; Organoplatinum Compounds; Oxonic Acid; Tegafur; Tomography, X-Ray Computed

Purpose The current standard treatment for locally advanced nasopharyngeal carcinoma (LANPC) is intensity-modulated radiation therapy (IMRT) plus cisplatin concurrent chemoradiotherapy (CCRT). However, this regimen has well-known hematological and gastrointestinal toxicities. Many studies have reported that S-1 was effective in the treatment of multiple solid cancers with mild toxicities. However, knowledge regarding IMRT plus S-1 CCRT in LANPC is lacking. Therefore, we conducted this prospective phase II trial to evaluate the efficacy and safety of this regimen in LANPC. Patients and Methods Eligible patients with histologically confirmed LANPC were enrolled in this study. IMRT was given in 30-32 fractions five times per week. Concurrently, S-1 was administrated twice per day orally based on the body surface area (BSA < 1.25 m

Topics: Adolescent; Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Chemoradiotherapy; Cisplatin; Drug Combinations; Female; Follow-Up Studies; Humans; Male; Middle Aged; Nasopharyngeal Neoplasms; Organoplatinum Compounds; Oxonic Acid; Paclitaxel; Prognosis; Prospective Studies; Radiotherapy, Intensity-Modulated; Survival Rate; Tegafur; Young Adult

Although standard chemotherapy for esophageal cancer patients is fluorouracil and cisplatin, the prognosis is still unsatisfactory. A new therapeutic regimen combining docetaxel, cisplatin, and 5-fluorouracil was recently developed to improve both local and distant tumor control. We developed a new regimen of docetaxel, nedaplatin, and S1 (DGS) and previously reported the recommended dose in a phase I dose-escalation study. We then undertook a phase II study of DGS for advanced esophageal squamous cell carcinoma. Patients with clinical stage IB/II/III disease were eligible. Patients received two courses of chemotherapy: docetaxel 35 mg/m(2) with nedaplatin 40 mg/m(2) on day 8, 80 mg/m(2) S1 on days 1-14, and 2 weeks off. After completion of chemotherapy, patients underwent esophagectomy. The primary endpoint was the completion rate of protocol treatment (completion of two courses of preoperative chemotherapy and R0 surgery [no residual tumor]). We enrolled 32 patients. The completion rate of protocol treatment was 96.9%. During chemotherapy, the most common grade 3 or 4 toxicity was neutropenia (25.0%). No treatment-related deaths were observed, and the incidence of operative morbidity was tolerable. The overall response rate after chemotherapy was 83.3%. This DGS regimen was well tolerated and highly active. This trial is registered with the University Hospital Medical Information Network (UMIN ID: 000014626).

Topics: Adult; Aged; Aged, 80 and over; Antineoplastic Agents; Carcinoma, Squamous Cell; Docetaxel; Drug Combinations; Esophageal Neoplasms; Esophageal Squamous Cell Carcinoma; Esophagectomy; Female; Humans; Kaplan-Meier Estimate; Male; Middle Aged; Neoadjuvant Therapy; Neoplasm Staging; Neutropenia; Organoplatinum Compounds; Oxonic Acid; Taxoids; Tegafur; Treatment Outcome

For patients with advanced non-small cell lung adenocarcinoma that fail to respond to first-line chemotherapy and that do not involve epidermal growth factor receptor (EGFR) mutations, previous empirical analysis showed that a single second-line chemotherapy agent may be inadequate for the control of further tumor development. This study examines the combination of S-1 drugs and nedaplatin that has no cross-resistance to first-line treatments; 179 cases of IIIb-IV stage non-small-cell lung adenocarcinoma that failed to respond to first-line chemotherapy were included, and these subjects did not have mutated EGFRs. In the present study, S-1 plus nedaplatin chemotherapy was better than standard second-line chemotherapy options in the treatment of advanced lung adenocarcinoma that did not involve EGFR mutations and that failed to respond to first-line chemotherapy. Additionally, the combination of S-1 and nedaplatin seemed to be well tolerated, making this chemotherapy technique a potentially strong candidate for the treatment of advanced non-small-cell lung adenocarcinoma.

Topics: Adenocarcinoma; Adult; Aged; Anemia; Antineoplastic Combined Chemotherapy Protocols; Carcinoma, Non-Small-Cell Lung; Disease-Free Survival; Drug Combinations; Drug Therapy; ErbB Receptors; Female; Humans; Logistic Models; Lung Neoplasms; Male; Middle Aged; Multivariate Analysis; Mutation; Nausea; Neoplasm Staging; Organoplatinum Compounds; Oxonic Acid; Tegafur; Treatment Failure; Treatment Outcome; Vomiting

We performed a pharmacokinetic phase I trial of the combination of S-1 granules and nedaplatin for head and neck squamous cell carcinoma (HNSCC).. Patients were treated with both nedaplatin on day 1 at a dose starting at 80 mg/m(2) (level 1) escalating up to 90 mg/m(2) (level 2), and S-1 granules at a daily dose of 80 mg/m(2) on days 1 to 14 every three weeks. The primary end-point was determination of the recommended dose.. Twenty patients were enrolled. Dose-limiting toxicities occurred in one out of six patients at dose level 1 (neutropenia) and in all three patients at level 2 (neutropenia and thrombocytopenia). The recommended dose was determined as level 1. Pharmacokinetic parameters of S-1 granule did not differ from the capsula formulation. The response rate was 42.1%.. This combination was well-tolerated and manifested a promising activity against HNSCC.

Topics: Aged; Antineoplastic Combined Chemotherapy Protocols; Carcinoma, Squamous Cell; Drug Combinations; Female; Head and Neck Neoplasms; Humans; Male; Middle Aged; Organoplatinum Compounds; Oxonic Acid; Tegafur

We previously reported on the regimen of S-1 plus nedaplatin (NDP), with S-1 was administered orally for 14 days and NDP intravenously on day 8. The maximum tolerated dose (MTD) of NDP was determined to be 90 mg/m². The main toxicities were neutropenia and thrombocytopenia. This result was tolerated, but we believe there is a more effective and tolerable regimen. Thus, we investigated the S-1 regimen administered orally for 14 days, and NDP intravenously on day 1 in patients with locally advanced head and neck squamous cell carcinoma.. Oral administration of S-1 (days 1-14) and intravenous NDP (day 1) were tested for patients with advance head and neck cancer in a phase I setting. The dose of S-1 was fixed and the dose of NDP was escalated from 70 mg/m², with an increase of 10 mg/m² per step, to find the MTD.. A total of 15 patients were registered. The MTD of NDP was determined to be 100 mg/m². The main toxicities were neutropenia and thrombocytopenia. The response rate (RR) was 57.1%.. The recommended dose of NDP for a phase II study was determined to be 100 mg/m². We concluded that our regimen was well tolerated and that the RR was acceptable.

Topics: Administration, Oral; Aged; Antineoplastic Agents; Carcinoma, Squamous Cell; Drug Administration Schedule; Drug Combinations; Drug Therapy, Combination; Female; Head and Neck Neoplasms; Humans; Male; Maximum Tolerated Dose; Middle Aged; Neutropenia; Organoplatinum Compounds; Oxonic Acid; Tegafur; Thrombocytopenia; Treatment Outcome

More effective regimens are urgently needed for treatment of esophageal carcinoma; therefore, we conducted a phase I trial of a combination of docetaxel, nedaplatin, and S-1 (DGS) to determine the optimal dose in patients with advanced esophageal carcinoma.. We studied 14 patients with previously untreated advanced cervical esophageal carcinoma with T3-4 tumors and/or M1 staging and esophageal carcinoma with cervical lymph node metastasis. The patients received an infusion of docetaxel at different dose levels (levels 1, 2, 3, 4: 25, 30, 35, 40 mg/m(2), respectively) and an infusion of nedaplatin (40 mg/m(2)) on day 8 plus oral administration of S1 (80 mg/m(2)/day) for two consecutive weeks at two-week intervals.. Dose-limiting toxicities (DLTs) included febrile neutropenia and leukopenia. DLTs occurred in 2 out of 5 patients at level 4. The response rate was 78.6 (11/14)%, including a complete response rate of 35.7(5/14)%.. The DGS regimen reported here was well tolerated and toxicities were manageable. The maximum tolerated dose was level 4, and the recommended dose was determined to be docetaxel at 35 mg/m(2) with nedaplatin at 40 mg/m(2) plus S1 at 80 mg/m(2). We found that our regimen, administered on an outpatient basis, showed high activity and tolerance. A phase II study has been started.

Topics: Adult; Aged; Aged, 80 and over; Antineoplastic Agents; Carcinoma, Squamous Cell; Docetaxel; Dose-Response Relationship, Drug; Drug Combinations; Esophageal Neoplasms; Female; Humans; Male; Middle Aged; Organoplatinum Compounds; Oxonic Acid; Taxoids; Tegafur; Tomography, X-Ray Computed

Cisplatin plus fluorouracil is widely used for the treatment of head and neck cancer. However, the cisplatin plus fluorouracil regimen necessitates hospitalization. Therefore, we planned to develop a new regimen that can be administered on an outpatient basis and performed a phase I study of S-1 + nedaplatin.. S-1 was given orally at a fixed dose for 14 days, and nedaplatin was administered intravenously on day 8 of S-1 administration. The dose of nedaplatin was increased in 10-mg/m(2) steps to find the maximum tolerated dose, depending on the appearance of dose-limiting toxicities.. A total of 14 patients were registered. The maximum tolerated dose of nedaplatin was determined to be 90 mg/m(2). The main toxicities were neutropenia and thrombocytopenia. The response rate was 57.1%.. The recommended dose of nedaplatin for a phase II study was determined to be 80 mg/m(2). We concluded that our regimen was well tolerated and that the response rate was acceptable.

Topics: Aged; Antineoplastic Combined Chemotherapy Protocols; Carcinoma; Carcinoma, Squamous Cell; Cisplatin; Disease Progression; Drug Combinations; Female; Fluorouracil; Head and Neck Neoplasms; Humans; Male; Maximum Tolerated Dose; Middle Aged; Neoplasm Recurrence, Local; Neoplasms, Squamous Cell; Organoplatinum Compounds; Oxonic Acid; Squamous Cell Carcinoma of Head and Neck; Tegafur

We have treated head and neck carcinoma by concurrent chemoradiotherapy combined with 5-fluorouracil (5-FU) and cisplatin (CDDP). However,this chemoradiotherapy could not show an enormous effect in the advanced carcinoma of Stage III and IV. Therefore,we changed the contents of the chemotherapy, i.e., we replaced 5-FU, one of the agents with time dependency, to continuous administration of TS-1 for 2 weeks,also replacing CDDP, one of the agents with dose dependency, to nedaplatin (CDGP) in order to reduce kidney dysfunction. In this concurrent chemoradiotherapy, oral TS-1 was continued for 2 weeks and CDGP was administered on the 4 th day from the start of TS-1. In addition, radiotherapy was performed concurrently. In this way,we performed a phase I clinical trial of concurrent chemoradiotherapy combining TS-1 and nedaplatin (CDGP). As for the incidence of adverse events,grade 3 mucositis due to radiation was observed in two patients. As a result of the phase I clinical trial,we decided the maximum-tolerated dose (MTD) of TS-1 to be 80 mg/m2 (maximum 120 mg/body) and 100 mg/m2 for CDGP, and then determined the recommended dose(RD) of TS-1 as 80 mg/m2 (maximum 120 mg/ body) TS-1 and of CDGP as 9 0 mg/m2 CDGP.

Topics: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Carcinoma, Squamous Cell; Combined Modality Therapy; Drug Administration Schedule; Drug Combinations; Female; Head and Neck Neoplasms; Humans; Male; Maximum Tolerated Dose; Middle Aged; Organoplatinum Compounds; Oxonic Acid; Pyridines; Radiotherapy Dosage; Tegafur

The present study aimed to retrospectively analyze the long-term efficacy and toxicity of concurrent chemoradiotherapy with nedaplatin and S-1 for head and neck squamous cell carcinoma.. The study enrolled 53 patients (23 with stage II disease, 13 with stage III disease, and 17 with stage IV disease). S-1 was administered orally twice a day for 14 days, followed by a two-week rest period. Nedaplatin was intravenously administered on day 4. Where possible, two courses of chemotherapy were performed. Radiotherapy was started with the administration of S-1. We analyzed the clinical response, survival rate, acute adverse events, and late swallowing toxicity.. The complete response rates for the primary tumor and neck lymph node metastases were 94.3% and 79.3%, respectively. The five-year overall survival rate was 79.5%, the five-year disease-specific survival rate was 84.8%, and the five-year relapse-free survival rate was 73.7%. The main acute adverse events were leukopenia, neutropenia, mucositis, and dermatitis. No patient had severe nephrotoxicity. Late swallowing toxicity was observed in 13 patients.. The low toxicity, and low nephrotoxicity of chemoradiotherapy with nedaplatin and S-1 have a positive impact on long-term survival. The combination of nedaplatin and S-1 can be used instead of cisplatin and 5-fluorouracil as a safer regimen, especially in patients with some complications and those requiring treatment in an outpatient setting.

Topics: Adult; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols; Chemoradiotherapy; Drug Combinations; Female; Head and Neck Neoplasms; Humans; Laryngeal Neoplasms; Male; Middle Aged; Mouth Neoplasms; Organoplatinum Compounds; Oxonic Acid; Pharyngeal Neoplasms; Squamous Cell Carcinoma of Head and Neck; Tegafur; Treatment Outcome

Standard chemoradiotherapy (CRT) using cisplatin (CDDP) and 5-fluorouracil (5-FU) is an optional treatment for patients with stage II-III esophageal cancer. However, there are some demerits in this regimen because CDDP administration requires a large transfusion volume and 5-FU must be continuously infused over 24 h. Therefore, hospitalization is unavoidable. We collected retrospectively the data of definitive CRT with nedaplatin and S-1 as carried out in our institution.. Patients with early and advanced esophageal cancer and relapsed esophageal cancer after radical surgery were included. Nedaplatin 80 mg/m(2) was given on days 1 and 29, and S-1 80 mg/m(2) on days 1-14 and 29-42. No prophylactic treatment with granulocyte colony stimulating factor was administered. Patients received two courses of concurrent radiotherapy of more than 50 Gy with or without two additional courses as adjuvant therapy every 4 weeks.. Between August 2011 and June 2015, 89 patients (age range, 44-86 years; K-PS 90-100, 81 %; squamous cell carcinoma histology, 97 %; definitive/salvage CRT, 75/25 %) were collected. Twenty-one (24 %) patients completed four cycles, and 94 % received two or more cycles. Grade 4 leukopenia, thrombocytopenia, and anemia occurred in 12, 7, and 10 % of the patients, respectively. Five patients developed febrile neutropenia. Grade 3 non-hematological toxicity included infection in 12 %, mucositis/esophagitis in 3 %, kidney in 3 %, and fatigue in 3 %. Sixty-four patients (72 %) received the prescribed full dose and full cycles of chemotherapy. A complete response was achieved in 76 patients (85 %). The 3-year overall survival rate was 54.4 % in definitive CRT and 39.8 % in salvage CRT, respectively. Sixty-two subjects (70 %) received treatment as outpatients.. Nedaplatin and S-1 in combination with radiotherapy is feasible, and toxicity is tolerable. This treatment method has the potential to shorten hospitalization without impairing the efficacy of CRT.

Topics: Adult; Aged; Aged, 80 and over; Ambulatory Care; Antineoplastic Combined Chemotherapy Protocols; Carcinoma, Squamous Cell; Chemoradiotherapy; Cisplatin; Drug Administration Schedule; Drug Combinations; Esophageal Neoplasms; Female; Fluorouracil; Hospitalization; Humans; Kaplan-Meier Estimate; Male; Middle Aged; Organoplatinum Compounds; Oxonic Acid; Retrospective Studies; Salvage Therapy; Tegafur

Nedaplatin and S-1 treatment with concurrent radiotherapy was effective, with acceptable toxicities. This regimen does not require extensive intravenous hydration and continuous infusion. Nedaplatin and S-1 may contribute to better clinical outcomes and improve quality of life for patients.. We retrospectively analyzed the clinical efficacy and toxicity of concurrent chemoradiotherapy with nedaplatin and S-1 for head and neck squamous cell cancer.. Forty-six patients with oropharyngeal, hypopharyngeal, and laryngeal cancer were treated with S-1 on days 1 through 14 and nedaplatin on day 1 every 4 weeks for two cycles of radiotherapy. Therapeutic responses and adverse events were assessed.. Primary site tumors and neck lymph nodes exhibited complete response rates of 91% and 64.3%, respectively. The 4-year relapse-free survival and overall survival rates were 76.2% and 85.3%, respectively. The main grade 3 and 4 toxicities were mucositis (30%), leukopenia (30%), anorexia (22%), dermatitis (15%), and thrombocytopenia (9%).

Topics: Adult; Aged; Aged, 80 and over; Antineoplastic Agents; Carcinoma, Squamous Cell; Chemoradiotherapy; Drug Combinations; Female; Head and Neck Neoplasms; Humans; Male; Middle Aged; Neoplasm Staging; Organoplatinum Compounds; Oxonic Acid; Retrospective Studies; Squamous Cell Carcinoma of Head and Neck; Tegafur; Treatment Outcome

We investigated the efficacy and toxicity of concurrent chemoradiotherapy with nedaplatin and S-1 for head and neck cancer, as an alternative to cisplatin and 5-fluorouracil.. A total of 31 patients were enrolled in this study. S-1 was administered orally twice a day for 14 days followed by a 2-week rest. Nedaplatin was intravenously administered on day 4. If possible, two courses of chemotherapy were performed. The radiotherapy was started concurrently with the administration of S-1.. The overall complete response rate was 81%. The 2-year overall survival rate was 96%. The 2-year relapse-free survival rate was 94%. The main adverse events were hematological toxicity, mucositis and dermatitis.. Our findings suggest that this therapeutic regimen has either an equal or lower toxicity than the conventional cisplatin and 5-fluorouracil, and that it has equal efficacy with regard to the clinical response and short-term outcome. Moreover, it is possible to successfully perform this treatment in an outpatient setting.

Topics: Aged; Antineoplastic Combined Chemotherapy Protocols; Carcinoma, Squamous Cell; Combined Modality Therapy; Drug Combinations; Female; Follow-Up Studies; Head and Neck Neoplasms; Humans; Lymphatic Metastasis; Male; Middle Aged; Neoplasm Staging; Organoplatinum Compounds; Oxonic Acid; Radiotherapy; Survival Rate; Tegafur; Treatment Outcome

Many reports have been published on the treatment for hypopharyngeal cancer, and the treatment modalities and results have become uniform to some extent. More specifically, reconstruction by means of free jejunal grafts has become widespread, and the results of surgical treatments have stabilized. On the other hand concurrent chemoradiotherapy has been widely performed, and the results from the standpoint of organ and function preservation have revealed the various differences between institutions. In our department, we have been using concurrent chemoradiotherapy for advanced cancer with a view to organ and function preservation. In this article, we report 6 cases with hypopharyngeal cancer treated by concurrent chemoradiotherapy with S-1 plus nedaplatin(SN therapy)in our department between January 2005 and December 2008. The complete response rate after SN therapy was 83. 3%, and the laryngeal preservation rate was 100%.

Topics: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Drug Combinations; Humans; Hypopharyngeal Neoplasms; Male; Middle Aged; Neoplasm Staging; Organoplatinum Compounds; Oxonic Acid; Tegafur

A 68-year-old man was admitted with hoarseness. Laryngofiberscopy showed a tumor that obstructed the posterior hypopharyngeal wall and the larynx, and biopsy revealed well-differentiated squamous cell carcinoma. CT demonstrated bilateral cervical lymph node metastases. The patient was diagnosed as having hypopharyngeal cancer(T4N2cM0)and was treated with concurrent S-1, nedaplatin and radiotherapy(hereafter referred to as SN therapy). CT and endoscopy after primary treatment showed disappearance of the tumor, and the treatment outcome was assessed as complete response(CR). Currently, the patient is being treated with S-1 as adjuvant chemotherapy in the outpatient setting, and no recurrence or metastasis has been observed. These results suggest that SN therapy was effective for advanced hypopharyngeal cancer from the viewpoint of both curative treatment and organ and function preservation.

Topics: Aged; Antineoplastic Combined Chemotherapy Protocols; Combined Modality Therapy; Drug Combinations; Humans; Hypopharyngeal Neoplasms; Male; Organoplatinum Compounds; Oxonic Acid; Tegafur; Tomography, X-Ray Computed

Laryngeal cancer is one of the most common types of head and neck cancer. Numerous studies have reported treatment outcomes, and therapeutic approaches and results are generally well established. However, the widespread use of concurrent chemoradiation therapy(CCRT)has led to differences among hospitals in laryngeal preservation rates in patients with T2 and T3 tumors. CCRT is the mainstay of treatment for laryngeal cancer in our department, given our goals of achieving organ and functional preservation, as well as radical cure. Our regimen for CCRT is comprised of chemotherapy with S-1 plus nedaplatin, concurrently with radiation therapy(SN therapy). We report outcomes obtained from 60 patients with laryngeal cancer who received first-line treatment in our department from April 2005 through March 2010. Cumulative survival rates according to disease stage were as follows: Stage I, 100%; Stage II, 96. 2%; Stage III, 83. 3%; and Stage IV, 48. 8%. The complete response rate after SN therapy was 84. 3%. After excluding patients with T4 tumors, the laryngeal preservation rate was 85. 7%.

Topics: Adult; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols; Drug Combinations; Female; Humans; Laryngeal Neoplasms; Male; Middle Aged; Neoplasm Staging; Organoplatinum Compounds; Oxonic Acid; Survival Rate; Tegafur; Treatment Outcome

Laryngeal cancer occurs more frequently in head and neck cancers, so there are a number of reports regarding the treatment results,wherein the therapeutic strategy and results are stable to some extent. However, due to the spread of chemoradiotherapy, there are differences in the larynx preservation rates for T2 and T3 cases, depending on the facility. Our department has been administering chemoradiotherapy for advanced cancer based on the perspective of conserving the organ and the function. We herein report our examination of 20 laryngeal cancer cases receiving concomitant therapy with S-1, Nedaplatin, and radiation (hereinafter, referred to as SN therapy) in our department from April 2005 to December 2008. The resulting complete response (CR) rate for the SN therapy was 82.4%, excluding T4 cases. Due to their refusal of surgery, 2 of 3 cases in which the SN therapy had been administered for T4 cases receiving SN therapy showed CR, wherein the CR rate in all cases after the SN therapy was 80. 0%. The larynx preservation rate after the SN therapy was 94.1%.

Topics: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Combined Modality Therapy; Drug Combinations; Female; Humans; Laryngeal Neoplasms; Male; Middle Aged; Neoplasm Staging; Organoplatinum Compounds; Oxonic Acid; Survival Rate; Tegafur; Voice Quality

There are a variety of reports on radiotherapy, combined chemotherapy with radiation (including arterial injection), block resection via surgery, and fractional resection for maxillary cancer, and currently various differences among facilities. In our department, we provide treatment with the aim of preserving the organs and functions in cases of head and neck malignant tumors. We herein report the effectiveness of treatment in 4 cases of maxillary cancer, using S-1, nedaplatin/radiation (SN) therapy at our department from January 2005 to December 2008. The cases comprised 4 patients, including 3 cases of T4N0M0 and 1 case of T2N0M0. All patients were males between 29 to 67 years old, wherein the mean was 52.3 years old. All cases resulted in survival without cancer after the application of the treatment policy of our department, wherein all functions were preserved. It is believed that the performance of SN therapy made it possible to minimize the scope of surgery and preserve the organs and functions. It will be necessary to increase the number of cases in order to examine the effectiveness of the organ and function preservation as well as the survival rate for maxillary cancer after SN therapy.

Topics: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Combined Modality Therapy; Drug Combinations; Humans; Male; Maxillary Neoplasms; Middle Aged; Neoplasm Staging; Organoplatinum Compounds; Oxonic Acid; Tegafur; Tomography, X-Ray Computed

It is not rare to observe multiple cancers in cases of head and neck carcinoma. Such cancers are important factors for deciding the therapeutic strategy. Complications of esophageal cancer are particularly frequent in cases of hypopharyngeal cancer in comparison to other head and neck tumors. At our department, for organ and functional preservation, and radical cure, we have used simultaneous therapy instead of separate therapy for head and neck tumors and esophageal cancer. We have been implementing concurrent S-1, nedaplatin/radiation therapy (hereinafter called SN therapy) for cases of advanced cancer of the head and neck, and we applied the same therapy for cases of head and neck carcinoma with esophageal cancer. The subjects comprised 5 cases of head and neck tumors complicated by esophageal cancer for which therapy was conducted at our department between April 2005 and March 2009. The histologic type was squamous cell carcinoma in all of the cases. There were 2 cases of laryngeal cancer (T3N2cM0, T3N0M0) and 3 cases of hypopharyngeal cancer (T3N2cM0, T4N2cM0, T3N2bM0). As a result, 3 out of the 5 cases have remained cancer-free, and the average observation period was 29. 3 months. One case expired due to an unrelated cause as a result of cardiac disease, while in the remaining case, the tumor did not disappear and the patient died due to the disease. It is necessary to continue examining the survival rate by increasing the number of cases.

Topics: Aged; Antineoplastic Combined Chemotherapy Protocols; Combined Modality Therapy; Drug Combinations; Esophageal Neoplasms; Fatal Outcome; Head and Neck Neoplasms; Humans; Male; Middle Aged; Organoplatinum Compounds; Oxonic Acid; Tegafur

Various treatments for oropharynx cancer included radiotherapy, arterial injection chemotherapy (as well as combined chemoradiotherapy), combined concurrent chemoradiotherapy, and surgical resection and reconstruction. There are also treatment differences among facilities. Our department has been providing a treatment modality for head and neck malignancies with the aims of functional and morphological preservation with a high cure rate. We herein report the treatment efficacy in 7 cases of oropharynx cancer (6 cases on lateral wall and 1 case on superior wall)treated with S-1, nedaplatin and radiotherapy (SN therapy) at our department between April 2006 and December 2006. The total of 7 cases included 1 case of T1N1M0, 1 of T2N0M0, 2 of T2N2bM0, 1 of T2N2cM0, 1 of T3N2cM0, and 1 case of T4N2cM0. The patients were all male and their ages ranged from 57 to 76 years old, with the average age of 68.4 years. Six of the 7 cases are surviving without cancer through treatment and their functions and morphologies have been preserved. In the 1 case of T4N2cM0, the tumor did not disappear and the patient expired due to the original lesion. Although SN therapy supposedly enables functional and morphological preservation, it is necessary to increase the number of cases and examine the efficacy of SN therapy for oropharynx cancer for functional and morphological preservation and the survival rate.

Topics: Aged; Antineoplastic Combined Chemotherapy Protocols; Combined Modality Therapy; Drug Combinations; Humans; Male; Middle Aged; Organoplatinum Compounds; Oropharyngeal Neoplasms; Oxonic Acid; Tegafur

Several clinical trials examining treatment strategies for advanced laryngeal cancer have demonstrated that concurrent chemoradiotherapy is the most effective treatment for improving the patient response to radiotherapy and laryngeal preservation. We evaluated a new regimen of S-1/CDGP(Nedaplatin) with radiotherapy (RT), and established that it represented an effective new treatment option that allowed for the preservation of the larynx.. A total of 16 patients with stage II to IV laryngeal cancer(excluding T4 stage)who had been treated at our institution from 2001 to 2007 were recruited for the present study. All patients had histologically-confirmed squamous cell carcinomas.. The administration of S-1/CDGP/RT led to a complete response (CCR) in all patients with stage II or IV disease, with preservation of the larynx in all of these cases. For patients with stage III disease, 6 (85%) experienced CR, and 1 patient (15%) had a partial response. The laryngeal preservation rate for these patients was 85%. Severe toxicities, i. e., neutropenia, thrombocytopenia, and dermatitis of grade 3, were observed. The overall five-year survival rate was 72%, and the disease specific survival rate was 92%.

Topics: Aged; Antineoplastic Combined Chemotherapy Protocols; Carcinoma, Squamous Cell; Combined Modality Therapy; Drug Combinations; Female; Humans; Laryngeal Neoplasms; Male; Middle Aged; Neoplasm Staging; Organoplatinum Compounds; Oxonic Acid; Survival Rate; Tegafur

The development of reconstructive surgery and the use of free flaps have allowed for a larger dissection range even for advanced tongue cancer, resulting in an improvement of the prognosis. However, both the postoperative swallowing and masticatory function are still considered to have not yet reached a satisfactory level. Accordingly, our department has been administering concurrent chemoradiotherapy (CCRT) for advanced cancer to preserve the organ and the function; there are cases in which even comparatively small tumors are difficult to dissect due to the occurrence site. We have been treating these cases using CCRT as well. We herein report our results of 10 tongue cancer cases in which CCRT with S-1 and Nedaplatin (hereinafter, referred to as SN therapy) was administered in our department from April 2002 to October 2008. The complete response rate of the SN therapy was 60. 0% (6 of 10 examples). The 5-year disease-specific survival rates were 50. 0% for Stage II, 75. 0% for Stage III, and 75. 0% for Stage IV, respectively.

Topics: Adult; Aged; Antimetabolites, Antineoplastic; Antineoplastic Agents; Antineoplastic Combined Chemotherapy Protocols; Combined Modality Therapy; Drug Combinations; Female; Humans; Male; Middle Aged; Organoplatinum Compounds; Oxonic Acid; Survival Rate; Tegafur; Tongue Neoplasms

A 77-year-old woman visited our hospital with the chief complaint of left supraclavicular lymph node redness and swelling. Needle biopsy revealed metastatic, epithelial, undifferentiated carcinoma. However, the primary tumor remained unknown despite further thorough examinations, FDG-PET showed abnormal FDG accumulation at the lymph nodes of para-aortic and left external iliac artery area in addition to left supraclavicular lymph node. However, CT and MRI showed no lymph node swelling in the peritoneal cavity. Nedaplatin (CDGP) combined with S-1 therapy was carried out for this primary unknown cancer with lymph node metastases. Three months after CDGP/S-1 therapy was begun, the swollen left supraclavicular lymph node was obviously reduced by 42.5%. Moreover, abnormal FDG accumulation at left supraclavicular and para-aortic lymph nodes dramatically decreased and that at the left external iliac artery area disappeared. The anti-tumor effect was evaluated as a partial response by use of Response Evaluation Criteria in Solid Tumors (RECIST). Standard treatment for primary unknown cancer was not established, because it includes various carcinomas. Here we report a case of primary unknown cancer successfully treated with CDGP/S-1. This combined therapy was considered to be one of the promising strategies for a primary unknown cancer.

Topics: Aged; Biopsy; Drug Combinations; Female; Humans; Neoplasms, Unknown Primary; Organoplatinum Compounds; Oxonic Acid; Positron-Emission Tomography; Tegafur; Ultrasonography

A 57-year-old man who had brown urine, jaundice and appetite loss from June 2006 was diagnosed with advanced pancreatic cancer. He received pylorus-preserving pancreatoduodenectomy in July 2006. Liver metastasis in S6 lesion was revealed by abdomen CT and SPIO-MRI in November and December 2006, respectively. Chemotherapy with gemcitabine hydrochloride (GEM) 1,400 mg/body was administered once a week on days 1, 8 and 15 for 4 weeks. At the beginning of this chemotherapy, it seemed to be a stable disease, but abdominal CT revealed a tumor progress in April 2007. So we selected combination chemotherapy with GEM and S-1 as second-line. At first serum CA19-9 was decreased but gradually increased, and the CT scan revealed the tumor progression in the liver and the local recurrence appeared in February 2008. So we selected combination chemotherapy with GEM and nedaplatin as third-line. After 2 months, CT scan revealed no change in tumor size. This combination chemotherapy can be effective in some patients with GEM-refractory pancreatic cancer.

Topics: Antineoplastic Combined Chemotherapy Protocols; Biomarkers, Tumor; Deoxycytidine; Drug Combinations; Gemcitabine; Humans; Liver Neoplasms; Male; Middle Aged; Organoplatinum Compounds; Oxonic Acid; Pancreatic Neoplasms; Recurrence; Tegafur; Tomography, X-Ray Computed

The present study evaluated the efficacy and safety of nedaplatin-combination therapy (NDP/5-FU [5-FU arm] or NDP/S-1 [S-1 arm] ) for the treatment of oral squamous cell carcinoma.. Previously non-treated oral squamous cell carcinoma patients were eligible. Patients received 5-FU 600 mg/m(2)iv, as a 24-hour infusion (day 1 to 5) followed by NDP 80 to 100 mg/m(2) iv (day 1), or S-1 60 to 80 mg/m(2) orally twice a day (day 1 to 14) followed by NDP 80 mg/m(2) iv (day 8) every 28 days for one or two cycles.. In total, 32 patients (18 in the 5-FU arm, 14 in the S-1 arm) were enrolled. Twenty patients were male and 12 were female. Median age was 57 years (range 20 years to 87 years). Thirty-one patients had a performance status (PS) oF 0, and 1 patient had a PS 1. Three patients were stage I, 12 stage III, and 12 were stage IV. The overall response rate was 69% (5-FU arm,72%;S-1 arm,64%). Two patients achieved a complete response, 20 patients a partial response, and 10 patients had no change. Grade 3 leucopenia, grade 3 and 4 thrombocytopenia and liver injury occurred in 6% (one in the 5-FU arm, and one in the S-1 arm), 9% (two in the 5-FU arm, and one in the S-1 arm), and 3% (one in the 5-FU arm), respectively. No other severe toxicities were observed.. Response rate and toxicities were similar in both arms. However, the psychosocial stress on patients in the S-1 arm was reduced compared to that in the 5-FU arm, which required hospitalization for a longer period. The outcome in the present study needs further investigation.

Topics: Administration, Oral; Adult; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols; Chemotherapy, Adjuvant; Drug Administration Schedule; Drug Combinations; Fluorouracil; Humans; Infusions, Intravenous; Leukopenia; Male; Middle Aged; Mouth Neoplasms; Nausea; Organoplatinum Compounds; Oxonic Acid; Tegafur; Thrombocytopenia; Vomiting, Anticipatory

Although surgery is treatment of choice for esophageal cancer, radiochemotherapy is being employed throughout Japan for the purpose of improving patient QOL. The results of this therapy are reported to be comparable to those associated with surgical treatment. However, since concomitant 5-FU/CDDP radiotherapy, currently the treatment of choice when implementing radiochemotherapy, is associated with a comparatively high incidence of gastrointestinal disorders and requires continuous intravenous infusion for 24 hours, it lowers the level of patient QOL. We have proposed a clinical study of concomitant TS-1/CDGP radiotherapy for the purpose of maintaining patient QOL and improving outcome. We conducted a pilot study prior to the phase I and II studies. The study was conducted on six cases and favorable results were obtained, consisting of a CR rate of 66.7% and a two-year survival rate of 50%. Although bone marrow inhibition was observed as an adverse side effect, gastrointestinal disorders that were discernible to the patients were extremely mild, and patient QOL was able to be maintained. CR was observed in 2 cases who were positive for DPD as determined by immunostaining. We are planning on conducting phase I and II studies in the future based on the potential for this treatment to contribute to the preservation of patient QOL and improve prognosis.

Topics: Antineoplastic Combined Chemotherapy Protocols; Combined Modality Therapy; Drug Administration Schedule; Drug Combinations; Esophageal Neoplasms; Female; Humans; Male; Organoplatinum Compounds; Oxonic Acid; Pilot Projects; Pyridines; Quality of Life; Survival Rate; Tegafur

The combination with cisplatin (CDDP) and 5-FU is considered the chemotherapy of choice for squamous cell carcinoma of the head and neck (HNSCC). TS-1, a modulation of tegafur developed in Japan, is an orally administered active agent for HNSCC. Some clinical phase I/II studies on the combination of CDDP and TS-1 have been reported. The combination showed a good response rate, 67.6% for both advanced and recurrent HNSCC, in our clinical phase II study. Regimens of TS-1 combined with carboplatin or nedaplatin are also reported.TS-1 containing regimens appear to be effective for HNSCC, and multi-institutional phase II studies with large sample size are needed in future. The combination TS-1 and radiotherapy, its dose and schedule,are being studied in phase I trials for advanced HNSCC. Patient compliance is better than with 5-FU injection because TS-1 is orally administered. The adverse effect, especially in terms of bone marrow toxicity, is equal or better than with 5-FU injection. The TS-1 combination with radiotherapy is a useful regimen for outpatients. The efficacy and adverse effects should be studied in carefully designed phase I/II trials. TS-1 will be one of the key drugs for HNSCC in future.

Topics: Antineoplastic Combined Chemotherapy Protocols; Carboplatin; Carcinoma, Squamous Cell; Cisplatin; Clinical Trials, Phase I as Topic; Clinical Trials, Phase II as Topic; Combined Modality Therapy; Docetaxel; Drug Administration Schedule; Drug Combinations; Fluorouracil; Head and Neck Neoplasms; Humans; Organoplatinum Compounds; Oxonic Acid; Pyridines; Taxoids; Tegafur