s-1-(combination) and Anus-Neoplasms

The patient was a 53-year-old woman who underwent colonoscopy for anal pain and melena. We diagnosed her with Stage I (T2N0M0) anal canal squamous cell carcinoma by biopsy specimen and CT scan. We recommended chemo-radiotherapy because she hoped to keep her anus. For this patient, we planned an S-1 administration at a dose of 120 mg/ body/day for consecutive 14 days followed by 7 days of rest period with whole pelvis and bilateral inguinal radiation (total 45 Gy/25 Fr). Then we added a booster radiation (14 Gy/7 Fr) to a local area for 5 days followed by 2 days of rest period. After 2 weeks of chemo-radiotherapy, we could not detect any tumors by colonoscopy. We diagnosed it as a pathological complete response for biopsy specimen.

Topics: Antimetabolites, Antineoplastic; Anus Neoplasms; Biopsy; Carcinoma, Squamous Cell; Chemoradiotherapy; Drug Combinations; Female; Humans; Middle Aged; Neoplasm Grading; Oxonic Acid; Tegafur

A Phase I/II trial of chemoradiotherapy concurrent with S-1 plus mitomycin C in patients with clinical Stage II/III squamous cell carcinoma of the anal canal was started in Japan. The aim of this trial is to determine the recommended dose of S-1 combined with a fixed dose of mitomycin C plus radiotherapy in Phase I and to evaluate the efficacy and safety in Phase II. The primary endpoint for the Phase II part of this study is the proportion of 3-year event-free survival, in which the following are defined as events: disease progression, residual tumor at the end of chemoradiotherapy, colostomy or death, whichever comes first. Secondary endpoints are progression-free survival, proportion of complete response and adverse events. In the Phase II part of this study, a total of 65 patients will be enrolled from 42 institutions over 6 years.

Topics: Adult; Aged; Antibiotics, Antineoplastic; Antimetabolites, Antineoplastic; Antineoplastic Combined Chemotherapy Protocols; Anus Neoplasms; Carcinoma, Squamous Cell; Chemotherapy, Adjuvant; Disease-Free Survival; Drug Combinations; Female; Humans; Male; Middle Aged; Mitomycin; Neoplasm Staging; Oxonic Acid; Patient Selection; Radiotherapy, Adjuvant; Tegafur; Treatment Outcome

An 82-year-old man who complained of constipation, anal pain, and bleeding was diagnosed with internal hemorrhoid in another hospital 6 months previously. At the time of our consultation, a tumor was observed in the anal canal. Computed tomography (CT) imaging revealed that the tumor extended to the front of the coccyx with abscess formation. Histological examination of biopsy specimens confirmed a diagnosis of adenocarcinoma. Since the patient refused to undergo surgery, we recommended chemoradiotherapy for relieving pain. A total of 60 Gy of irradiation was administered to the lesser pelvis, and chemotherapy was initiated with S-1 at a dose of 8 0mg/day for 14 consecutive days followed by 7 days of rest. Subsequently, tumor reduction was seen and the pain was controlled. The patient showed improvement in activities of daily living (ADL). Currently, the patient continues to receive S-1 therapy. We conclude that chemoradiotherapy is useful as a palliative therapy in anal mucinous carcinoma.

Topics: Adenocarcinoma; Aged, 80 and over; Antimetabolites, Antineoplastic; Anus Neoplasms; Chemoradiotherapy; Drug Combinations; Humans; Male; Oxonic Acid; Palliative Care; Tegafur

The patient was a 65-year-old man who underwent colonoscopy for melena. Following a biopsy, the patient was diagnosed with anal canal squamous cell carcinoma. A computed tomography (CT) scan revealed metastasis to the regional lymph nodes. The proposed treatment regimen comprised radiotherapy combined with S-1 and mitomycin C (MMC). Dur- ing radiotherapy (59.6 Gy in 32 fractions), 10mg/m² MMC was administered, as an intravenous bolus injection, on days 1 and 29. S-1 was administered orally, at a dose of 80 mg/m², on days 1-14 and 29-42. No serious adverse events were observed during chemoradiotherapy; the observed adverse events were leukemia (Grade 2), diarrhea (Grade 1), anorexia (Grade 1), and radiation dermatitis (Grade 1). After 8 weeks of treatment, no tumors, only scar tissue could be detected by using colonoscopy, and a CT scan revealed a remarkable reduction in regional lymph node metastases. The patient achieved a complete response.

Topics: Aged; Antineoplastic Combined Chemotherapy Protocols; Anus Neoplasms; Carcinoma, Squamous Cell; Chemoradiotherapy; Drug Combinations; Humans; Male; Mitomycin; Oxonic Acid; Tegafur

We present a case in which chemoradiation therapy was effective in a geriatric patient with Stage IV anal canal cancer. The patient is an 81-year-old woman who complained of proctorrhagia and anal pain. She was referred to us by her family doctor who suspected rectal cancer. Tumors as large as 6.5 cm in diameter mainly on the right side of the rectum as well as 2 palpable enlarged lymph nodes on the right inguinal area, were found during the initial physical examination. Squamous cell carcinoma was elevated to 16 ng/mL. A CT scan revealed that irregularly shaped masses as large as 7 cm in diameter were externally exposed on the right side of the rectum along with enlarged lymph nodes on the right inguinal area and metastasis at S7 lesion in the liver. Squamous cell carcinoma was diagnosed from biopsy results. Due to her age, the chemotherapy regimen was S-1+CDDP with radiation therapy and 4-port irradiation (50.4 Gy) of the primary tumor, interior of the pelvis, and inguinal lymph nodes. Partial response was observed upon completion of treatment, and complete response was obtained after 6 months. She is currently an outpatient taking S-1: 60 mg/day orally. There is no indication of cancer recurrence after 1 year and 3 months, and she continues to visit an outpatient clinic for regular follow-ups. These results demonstrate the effectiveness of chemoradiation therapy for geriatric patients with Stage IV anal canal cancer.

Topics: Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols; Anus Neoplasms; Carcinoma, Squamous Cell; Chemoradiotherapy; Cisplatin; Drug Combinations; Female; Humans; Neoplasm Staging; Oxonic Acid; Tegafur

We report a case of anal cancer in a 58-year-old woman who complained of narrow, bloody stools and anal pain. Physical examination revealed anal stenosis associated with a circular mass arising in the anal canal. Histological examination of biopsy specimens confirmed a diagnosis of moderately differentiated squamous cell carcinoma. Enhanced computed tomography revealed anal cancer invading the levator ani and the vagina, with lymph-node, multiple hepatic, and pulmonary metastases. The patient received two cycle of chemoradiotherapy with S-1 plus low-dose cisplatin with rest for 4 weeks, leading to complete response of the primary lesion and a partial response of the metastatic lesions. Each cycle included oral S-1 (120 mg/body; day 1-21), cisplatin (10 mg/body; day 1-5, 8-12) and radiotherapy (2 Gy/day; day 1-5, 8-12, 15-19). Adverse effects of treatment were mild perineal skin erosion and mild appetite loss, but no hematologic toxicity. Although the patient died 16 months after first admission, chemoradiotherapy with S-1 plus cisplatin is potentially effective for the management of advanced anal cancer.

Topics: Antineoplastic Combined Chemotherapy Protocols; Anus Neoplasms; Chemoradiotherapy; Cisplatin; Drug Combinations; Female; Gamma Rays; Humans; Liver Neoplasms; Lung Neoplasms; Lymphatic Metastasis; Middle Aged; Neoplasm Staging; Oxonic Acid; Tegafur; Treatment Outcome

A 79-year-old woman was reffered to our hospital with the chief complaint of hematochezia. Type-2 tumor was found on anal canal by colonoscopy, and pathologic examination revealed a poorly differentiated squamous cell carcinoma. Computed tomography of the abdomen demonstrated obturatory node metastasis. The patient was diagnosed as having squamous cell carcinoma of the anal cana (l cStage III). After four months from chemoradiation (66 Gy/33 Fr plus S-1), the ulcer side was improved completely to epithelization, and abdominal CT scan showed a remarkable reduction of obturatory node metastasis. She was obtained a complete response. Now the patient is disease-free for ten months after chemoradiation.

Topics: Aged; Antimetabolites, Antineoplastic; Anus Neoplasms; Carcinoma, Squamous Cell; Chemoradiotherapy; Drug Combinations; Female; Humans; Lymphatic Metastasis; Neoplasm Staging; Oxonic Acid; Tegafur; Tomography, X-Ray Computed

We report a case of left inguinal lymph node metastasis of anal canal carcinoma, treated effectively with chemotherapy consisting of S-1 and CDDP combined with radiotherapy. In February 2006, a 76-year-old woman underwent resection of a tumor diagnosed as squamous cell carcinoma of the anal canal. The patient refused additional surgical therapy. In August 2007, a painful lymphnode swelling was noticed in the left inguinal region. Biopsy was performed, and specimens were shown to include squamous cell carcinoma cells. The patient was treated using chemotherapy concurrent with radiotherapy. The chemotherapy consisted of oral S-1 (80 mg/body/day; 5 days/week) and intravenous CDDP (5 mg/body/day; 5 days/week), both administered for 4 weeks. Radiotherapy at 2 Gy/day was administered 25 times (total dose 50 Gy). The metastatic tumor in the lymph node responded well to the treatment and decreased remarkably in size by December 2007. After chemoradiotherapy, the oral administration of S-1 alone (80 mg/body) for 2 weeks followed by a 2-week rest period as one course was continued for 1 year. The lymph node metastasis had disappeared 1 year after chemoradiotherapy, as determined by computed tomography (CT) and positron emission tomography-CT, representing a complete response. Chemotherapy consisting of S-1 and CDDP concurrent with radiotherapy maybe effective for treating metastatic lymph node metastasis of anal canal carcinoma.

Topics: Administration, Oral; Aged; Anal Canal; Antimetabolites, Antineoplastic; Antineoplastic Agents; Antineoplastic Combined Chemotherapy Protocols; Anus Neoplasms; Carcinoma, Squamous Cell; Cisplatin; Combined Modality Therapy; Drug Combinations; Female; Humans; Inguinal Canal; Injections, Intravenous; Lymphatic Metastasis; Oxonic Acid; Radiotherapy Dosage; Tegafur