s-1-(combination) and Carcinoma--Small-Cell

Small cell carcinoma of the esophagus (SCCE) is an uncommon but lethal disease characterized by dismal prognosis. Only 10% of advanced SCCE patients survive longer than 1 year. Resection is a choice for limited-stage cases, whereas the optimal treatment regimen for primary SCCE is yet to be elucidated. To the best of our knowledge, the efficacy of S-1 plus apatinib for irinotecan-refractory SCCE has not been reported before.. A 61-year old, previously healthy male was admitted for dysphagia and fatigue. Endoscopic biopsy revealed a tumor in the middle third of the esophagus. Further exams including abdomen computed tomography excluded distant metastasis.. Primary SCCE (pT1bN1M0, IIB) was established after salvage operation.. The tumor was enlarged after 1 cycle of first-line chemotherapy using irinotecan plus cisplatin, which indicated drug resistance. Second-line oral apatinib (425 mg daily) plus S-1 (60 mg, twice daily for 4 weeks with a 2-week drug-free interval) for a month showed efficacy, as shown by decreased serum neuron-specific enolase and stable of the esophageal lesion. Thereafter, salvage minimally invasive Ivor-Lewis esophagectomy and 2-field lymph node dissection was performed, followed by oral apatinib plus S-1 at the prior dosage for 6 months. In addition, maintenance therapy using low-dose apatinib (250 mg daily) plus S-1 (40 mg, twice daily for 4 weeks with a 2-week interval) were administered for another 6 months. Then the patient was followed up irregularly at the outpatient clinic.. The adverse events including hand-foot syndrome, hypertension, vomiting, leukopenia, impaired hepatic function, and fatigue were mainly tolerable. Forty months after the operation, he was readmitted for back pain and disseminated bone metastases appeared in magnetic resonance images. His progression-free survival could not be obtained precisely, and his overall survival was longer than 40 months up to September 2019.. S-1 plus apatinib followed by a timely esophagectomy with curative intent might be an alternative option for chemotherapy-refractory SCCE in selected patients. Better evidence is warranted.

Topics: Antimetabolites, Antineoplastic; Carcinoma, Small Cell; Drug Combinations; Drug Resistance, Neoplasm; Drug Therapy, Combination; Esophageal Neoplasms; Esophagectomy; Humans; Irinotecan; Male; Middle Aged; Oxonic Acid; Protein Kinase Inhibitors; Pyridines; Salvage Therapy; Tegafur

The management of extrapulmonary small cell carcinoma has not been standardised to date. This study reviewed the clinical course, management and survival outcomes of patients with extrapulmonary small cell carcinoma in the head and neck region.. Nine patients with extrapulmonary small cell carcinoma in the head and neck were included in this study.. Five patients received radical surgery followed by adjuvant chemotherapy or radiotherapy or both. Two other patients were treated with chemotherapy consisting of CPT11 plus cisplatin or CPT11 plus cisplatin plus VP-16 three times. Two other patients received chemoradiotherapy consisting of S-1 or CPT11 plus cisplatin. The median overall survival was 14.5 months, with a three-year survival rate of 23.7 per cent.. The prognosis of extrapulmonary small cell carcinoma is generally poor. Further prospective multicentre studies are required for better understanding of disease entities and response to treatment modalities.

Topics: Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols; Camptothecin; Carcinoma, Small Cell; Chemoradiotherapy; Chemotherapy, Adjuvant; Cisplatin; Disease Progression; Drug Combinations; Etoposide; Female; Head and Neck Neoplasms; Humans; Irinotecan; Male; Middle Aged; Neoplasm Staging; Oxonic Acid; Radiotherapy, Adjuvant; Survival Rate; Tegafur

Gastrointestinal tract endoscopy revealed the presence of a 5-cm-diameter type 3 tumor in the cardiac portion of the stomach. The tumor was chromogranin positive, and stomach small cell cancer was diagnosed by immunostaining and biopsy pathology. S-1+CDDP therapy was administered as the first-line treatment. A switch to S-1 monotherapy was made after the patient experienced grade 4 hyponatremia. However, following 7 courses of therapy the disease had progressed. Second-line chemotherapy of CPT-11+CDDP was initiated and after 2 courses the disease stabilized.

Topics: Aged; Antimetabolites, Antineoplastic; Antineoplastic Combined Chemotherapy Protocols; Camptothecin; Carcinoma, Small Cell; Cisplatin; Drug Combinations; Female; Humans; Irinotecan; Neoplasm Staging; Oxonic Acid; Stomach Neoplasms; Tegafur

Small cell carcinoma of the esophagus (SmCCE) is a rare disease which is considered to be more malignant than the most common types of esophageal cancer. The optimal treatment strategy for this disease still remains controversial. A 69-year-old male was diagnosed to have SmCCE (stage IIIA, T3N1M0). Due to the patient's poor general condition, chemo-radiotherapy consisting of S-1/cisplatin therapy and a total of 60 Gy of radiotherapy was performed. After the treatment, the main lesion completely disappeared while some ulceration remained. A histological examination revealed no viable cancer cells in biopsy specimens obtained by endoscopy. Computed tomographic examinations showed a decreased wall thickness of the esophagus and an improvement in the swelling of the lymph nodes. S-1 monotherapy was administered following the main chemoradiation therapy, and it was performed for a total of 20 courses. The patient has been doing well without recurrence for over 3 years. We judged the effect to be a complete response. This combination chemo-radiotherapy with S-1 and cisplatin may therefore be one of the effective treatments against SmCCE.

Topics: Aged; Antineoplastic Combined Chemotherapy Protocols; Asthma; Carcinoma, Small Cell; Cisplatin; Combined Modality Therapy; Diabetes Mellitus; Drug Combinations; Esophageal Neoplasms; Humans; Hypertension; Male; Neoplasm Staging; Oxonic Acid; Radiotherapy; Remission Induction; Tegafur

Gastric endocrine cell carcinoma is known to be highly malignant with a poor prognosis, and no standard treatment has been established. We experienced a case of endocrine cell carcinoma of the stomach with liver and lymph node metastases. The lesions became resectable at curability B after chemotherapy with S-1/cisplatin (CDDP). A 59-year-old man, who had no specific complaint, had gastrointestinal endoscopy for screening. A 30-mm tumor was found at the greater curvature of the lower body of the stomach, and was histologically diagnosed as an endocrine cell carcinoma from the biopsy specimen. A computed tomography (CT) scan and abdominal magnetic resonance imaging (MRI) showed masses at S5 and S6 of the liver, and No. 4 lymph node enlargement. Diagnosed as gastric endocrine cell carcinoma with liver and lymph node metastases, he was referred to our hospital. We started chemotherapy with a daily dose of S-1 administered on days 1 to 14 and CDDP of 70 mg/m(2) on day 8, every 4 weeks. After three courses of treatment, the primary lesion became a small scar and the metastatic lesions vanished from the CT and MRI. Then we performed distal gastrectomy with lymph node dissection and partial liver resectomy. Histological findings revealed no cancer cells, except for a few cells in the S5 liver lesion.

Topics: Antimetabolites, Antineoplastic; Antineoplastic Combined Chemotherapy Protocols; Carcinoma, Small Cell; Cisplatin; Drug Combinations; Gastrectomy; Humans; Liver Neoplasms; Lymphatic Metastasis; Magnetic Resonance Imaging; Male; Middle Aged; Oxonic Acid; Stomach Neoplasms; Tegafur; Tomography, X-Ray Computed

Gastric small cell carcinomas are rather rare. The incidence of small cell carcinomas of all histological types of gastric tumors is about 0.1%. Small cell carcinoma is a very aggressive cancer with a poor prognosis,and there is no effective chemotherapy to date. We experienced a case of small cell carcinoma of the stomach with relatively long survival from combination chemotherapy. A 75-year-old man underwent total gastrectomy, and liver metastasis was recognized 5 months postoperatively. We used combination chemotherapy with tegafur/gimeracil/oteracil potassium+cisplatin and irinotecan hydrochloride+cisplatin, and he has obtained a long survival time. We should gather more chemotherapy cases and establish some effective regimens for small cell carcinoma of the stomach.

Topics: Adenocarcinoma; Aged; Antineoplastic Combined Chemotherapy Protocols; Camptothecin; Carcinoma, Small Cell; Chemotherapy, Adjuvant; Cisplatin; Drug Administration Routes; Drug Combinations; Gastrectomy; Humans; Irinotecan; Lymph Node Excision; Male; Oxonic Acid; Stomach Neoplasms; Survivors; Tegafur

We herein report a case of gastric small cell carcinoma (GSCC), which was successfully treated by surgery and postoperative chemotherapy consisting of cisplatin (CDDP) and the fluoropyrimidine S-1. The patient was a 63-year-old man in whom a gastric tumor had been endoscopically detected. The type 1 tumor was located in the gastric body. An abdominal computed tomogram showed many metastasized nodes around the stomach. A total gastrectomy with regional node dissection was performed. The removed tumor was histologically and histochemically diagnosed to be a GSCC with node metastases. Furthermore, washing peritoneal cytology histologically revealed the presence of carcinoma cells. Metastasis was histologically observed in 17 of 24 dissected nodes. After surgery, CDDP was intravenously administered and S-1 was orally administered for 1 year. Consequently, the patient is now well without any recurrence 45 months after surgery. We reviewed 52 Japanese patients with GSCC/endocrine cell carcinoma (EC) reported between 2001 and 2005 with reference to chemotherapy. Chemotherapy using S-1 was performed for 11 of the 52 patients. Four of the 11 patients, including the present case, who were treated with S-1 survived for over 2 years after surgery, although the GSCC/EC of the four patients were staged as III or IV. Therefore, chemotherapy consisting of CDDP and S-1 may provide a survival benefit for patients with GSCC/EC.

Topics: Antimetabolites, Antineoplastic; Antineoplastic Agents; Carcinoma, Small Cell; Cisplatin; Diagnosis, Differential; Drug Combinations; Drug Therapy, Combination; Endoscopy, Gastrointestinal; Follow-Up Studies; Gastrectomy; Humans; Male; Middle Aged; Neoplasm Staging; Oxonic Acid; Postoperative Period; Stomach Neoplasms; Tegafur; Tomography, X-Ray Computed

We herein report a case of advanced gastric small cell carcinoma treated by chemotherapy and radiotherapy. A 69-year-old man was admitted to our hospital presenting with appetite loss and body weight loss. He was diagnosed to have an inoperable gastric small cell carcinoma with severe lymph node metastases and left adrenal gland metastasis. Chemotherapy with TS-1/paclitaxel, cisplatin/irinotecan and cisplatin/etoposide was sequentially performed. Primary and metastatic foci had obviously diminished. Eighteen months after the initial therapy, he had dysarthrosis and multiple brain metastases were found. Metastatic foci were decreased and his symptom was improved by successful radiotherapy. We conclude that chemotherapy and radiotherapy are effective for primary and metastatic lesions of gastric small cell carcinoma.

Topics: Aged; Antineoplastic Combined Chemotherapy Protocols; Brain Neoplasms; Camptothecin; Carcinoma, Small Cell; Cisplatin; Combined Modality Therapy; Cranial Irradiation; Drug Administration Schedule; Drug Combinations; Etoposide; Humans; Irinotecan; Lymph Nodes; Lymphatic Metastasis; Male; Oxonic Acid; Paclitaxel; Stomach Neoplasms; Tegafur

Endocrine cell carcinoma (ECC) of the stomach is a rare pathological type with a poor outcome. Standard chemotherapy has not yet been established. We experienced a case of partial response in the liver metastasis from the gastric ECC treated with TS-1. The patient was a 68-year-old female. An upper GI series and gastroendoscopy revealed pyrolus stenosis and CT-scan showed liver metastasis. A non-curative total gastrectomy was performed to allow oral intake. Since the histopathological examination revealed that tumor cells were partially positive for chromogranin A on immunohistochemical study, we diagnosed tumor ECC of the stomach. The patient with liver metastasis was treated using TS-1, and CT-scan showed a remarkable decrease (PR) in the metastatic lesion. TS-1 administration can improve the clinical outcome for ECC of the stomach.

Topics: Aged; Antimetabolites, Antineoplastic; Carcinoma, Small Cell; Combined Modality Therapy; Drug Administration Schedule; Drug Combinations; Female; Gastrectomy; Humans; Liver Neoplasms; Oxonic Acid; Remission Induction; Stomach Neoplasms; Tegafur

A 75-year-old male patient with small cell carcinoma of the stomach and liver metastasis was treated by combined chemotherapy of TS-1 and CDDP. One course consisted of TS-1 (120 mg/day) administered for 14 days followed by 14 days rest. CDDP (108 mg/day) was administered by 24-hour continuous intravenous infusion at day 8 after the start of TS-1. After 3 courses, endoscopic examination revealed complete disappearance of the primary tumor with no cancer cells detected by endoscopic biopsy. CT-scan showed that the metastasis of the left lobe of the liver had disappeared and also that the metastasis of the right lobe of the liver was remarkably reduced (75%). The primary lesion was estimated CR, the metastasis PR, and the synthesis PR. The TS-1/CDDP chemotherapy regimen is considered effective for small cell carcinoma of the stomach with liver metastasis.

Topics: Aged; Antineoplastic Combined Chemotherapy Protocols; Carcinoma, Small Cell; Cisplatin; Drug Administration Schedule; Drug Combinations; Humans; Liver Neoplasms; Male; Oxonic Acid; Pyridines; Remission Induction; Stomach Neoplasms; Tegafur