s-1-(combination) and Hypopharyngeal-Neoplasms

Reduced-RADPLAT for HPC achieved comparative survival and locoregional control rates with lower toxicities compared with concurrent chemoradiotherapies including original RADPLAT. S-1 adjuvant chemotherapy showed a survival benefit.. To evaluate the efficacy and toxicities of targeted intra-arterial (IA) infusion of cisplatin with concurrent radiotherapy with a reduced dose (reduced-RADPLAT) for resectable hypopharyngeal cancer (HPC).. Between 1999-2012, 50 patients with stage II-IVA HPC primarily treated by reduced-RADPLAT were analyzed. They were treated by 2-5 courses of IA cisplatin infusion (100 mg per body) with simultaneous systemic infusion of sodium thiosulfate concurrent with conventional radiotherapy (66-70 Gy). After 2003, S-1, an oral fluoropyrimidine, adjuvant chemotherapy was administered to all eligible patients.. During a median follow-up of 48.6 months, the estimated 3- and 5-year overall survival (OS), progression-free survival (PFS), locoregional control, and laryngoesophageal dysfunction-free survival (LEDFS) rates were 76.0% and 62.0%, 58.0% and 50.0%, 66.0% and 62.0%, and 56.0% and 54.0%, respectively. Grade 3 toxicities were observed in 30.0%. No patient had grade 4 or higher toxicities. No patient required tube feeding or tracheotomy at 3 months after treatment. T4-lesions and S-1 administration were significant factors predicting poor and good OS, PFS, and LEDFS, respectively.

Topics: Aged; Aged, 80 and over; Antineoplastic Agents; Carcinoma, Squamous Cell; Chemoradiotherapy; Chemotherapy, Adjuvant; Cisplatin; Drug Combinations; Female; Humans; Hypopharyngeal Neoplasms; Infusions, Intra-Arterial; Male; Middle Aged; Oxonic Acid; Retrospective Studies; Tegafur; Treatment Outcome

The objective of this study was to analyze the outcome of hypopharyngeal cancer patients who underwent triple combination treatment with S-1, vitamin A and radiation(TAR therapy), and to analyze the role of TAR therapy for treating locally advanced hypopharyngeal cancer patients. 146 patients(stage I: 10 cases, stage II : 22 cases, stage III : 23 cases, stage IV: 91 cases)with hypopharyngeal squamous cell carcinoma were treated with TAR therapy(S-1; orally, 65mg/m²day, twice a day; vitamin A(retinol palmitate): 50, 000 I U/day, intra-musculary on each day of radiation; radiation: 1. 5-2 Gy/day, 5 days/week). Histologic complete responders at 30-40 Gy continued TAR therapy up to 60-70 Gy. Nonresponders at 30-40 Gy underwent surgery. The overall 5-year survival and disease-specific 5-year survival rates were 50. 5%and 59%respectively. The cumulative 3-year laryngeal preservation rate for stage I was 100%, 82. 5% for stage II, 66. 6% for stage III, and 35%for stage IV. Laryngeal preservation was fair in T1/T2 patients(81%), but not satisfactory in T3/T4 patients(21. 4%). S- 1 is administered orally, and TAR therapy can be conducted in the clinic with low toxicity. However, protocols with high intensity may be necessary to improve laryngeal preservation for locally advanced(T4)hypopharyngeal cancer.

Topics: Adult; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols; Chemoradiotherapy; Drug Combinations; Female; Humans; Hypopharyngeal Neoplasms; Larynx; Male; Middle Aged; Neoplasm Staging; Oxonic Acid; Prognosis; Tegafur; Vitamin A

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

We reported the efficacy of concurrent chemoradiotherapy(CCRT)for cervical lymph node metastasis in patients with oropharyngeal or hypopharyngeal squamous cell carcinoma. The subjects were 17 patients with oropharyngeal or hypopharyngeal cancer with cervical lymph node metastasis, who underwent CCRT treatment between January 2005 and December 2009. The proportion of patients showing a complete response(CR)was 64. 7%; however, if patients without any residual viable cancer cells in the specimens obtained by neck dissection were also defined as CR, then, 82. 4% achieved CR. Thus, CCRT showed good efficacy without the need for planned neck dissection(PND). The limited recurrence cases and absence of serious complications associated with neck dissection after CCRT suggested that PND is not necessarily required. However, since assessment of cervical lymph nodes after CCRT is difficult, it would be desirable to develop a reliable examination and to study the most suitable examination for detecting the presence/absence of cervical lymph node metastasis.

Topics: Adult; Aged; Aminohydrolases; Antineoplastic Combined Chemotherapy Protocols; Combined Modality Therapy; Drug Combinations; Female; Humans; Hypopharyngeal Neoplasms; Lymphatic Metastasis; Male; Middle Aged; Neck; Oropharyngeal Neoplasms; 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

The patient was a 70-year-old male with superficial hypopharyngeal cancer and advanced cancers of the esophagus and stomach. In his past history, a cardiac pacemaker was implanted for sick sinus syndrome. Further examination showed esophageal cancer had metastasized to the cervical lymph nodes and invaded the trachea. There was no surgical indication. In terms of chemoradiotherapy, it was thought to be possible because the patient was not pacemaker- dependent and radiotherapy could be planned in such a way as to keep the dose to the pacemaker as low as possible. Electrocardiogram was monitored during the treatment. In addition to the usual observation, the patient's cardiac symptoms and pacemaker status were assessed before and soon after the completion of radiotherapy. S-1 was selected as a concomitant chemotherapy. In liaising with the cardiologist and radiologist, chemoradiotherapy was achieved without pacemaker malfunction, and shrinking of tumors was also detected.

Topics: Aged; Antimetabolites, Antineoplastic; Combined Modality Therapy; Drug Combinations; Electrocardiography; Esophageal Neoplasms; Humans; Hypopharyngeal Neoplasms; Male; Neoplasms, Multiple Primary; Oxonic Acid; Pacemaker, Artificial; Sick Sinus Syndrome; Stomach Neoplasms; Tegafur

Palliative treatments are applied for older adult cases that are not indicated for either surgery or potential chemotherapy, as well as in cases with unresectable primary lesions, distant metastases, and serious complications among head and neck cancer cases. There is no established treatment for such cases, and therefore treatment has to be selected on a case-by-case basis. Two cases showing sustained QOL after long administration of S-1 are presented in this paper. The first is an 84-year-old male patient with cancer of the hypopharynx (T3N2aM1, stage IVc). The second is a 70- year-old male patient who had recurrent cancer of the larynx (T1N0M0, stage I) after primary treatment. However, we were unable to perform surgery due to possible complications of severe emphysema. Regulating the dosage and intervals of S-1 enabled the patients in both cases to survive with cancer as outpatients for 2 years and 2 months after the initial visit (1 year and 10 months from the start of the administration of S-1) in the former case and 3 years from the initial visit (2 years and 1 month from the start of the administration of S-1) in the latter case.

Topics: Aged; Aged, 80 and over; Antimetabolites, Antineoplastic; Carcinoma, Squamous Cell; Drug Combinations; Humans; Hypopharyngeal Neoplasms; Laryngeal Neoplasms; Male; Oxonic Acid; Quality of Life; Tegafur

We report two successful remnant and recurrent cases of head and neck cancer treated with S-1. Case 1, a 52-year-old man, was diagnosed as supraglottic laryngeal carcinoma (T3N2cM0, squamous cell carcinoma: SCC) on January 25, 2000, and concurrent chemoradiotherapy (CCRT) was applied. After the treatment, a remnant tumor in the larynx was found by biopsy. He was followed using UFT at 400mg/day because he had refused surgery. Pulmonary metastasis was detected by chest CT on June 14, 2001, and the administration of S-1 was started. After 2 courses, the mass in the lung disappeared, and the primary lesion was also judged to be a complete response(CR). The administration of S-1 is still continuing and remnant tumors have not been found. Case 2, a 76-year-old man, was diagnosed with hypopharyngeal carcinoma (T3N2bM0, SCC) on December 14, 2001, and CCRT was applied resulting in CR in the hypopharynx and the neck. He was followed using UFT at 300 mg/day after discharge. A supraclavicular lymph node became palpable on March 27, 2003. Pathological examination by fine needle aspiration cytology showed SCC, class V. After 2 courses administering S-1 at 100mg/day, the supraclavicular lymph node disappeared. S-1 was changed to UFT at 300 mg/day on July 31, 2003, because adverse events of grade 3 appeared. Administration of UFT was continued for one year. No recurrence has been found for 5 years.

Topics: Aged; Antineoplastic Agents; Antineoplastic Combined Chemotherapy Protocols; Carcinoma, Squamous Cell; Drug Combinations; Head and Neck Neoplasms; Humans; Hypopharyngeal Neoplasms; Laryngeal Neoplasms; Lung Neoplasms; Male; Middle Aged; Oxonic Acid; Tegafur; Tomography, X-Ray Computed; Treatment Outcome

The results presented here provide evidence of the enhancing effect of oral fluoropyrimidine derivative S-1 in concomitant chemoradiotherapy for head and neck cancer and further insights into its biological mechanism.. To investigate the additive effect of S-1 and radiation for human hypopharyngeal cancer.. Nude mice bearing hypopharyngeal cancer cells (H891) were used for an in vivo model. S-1 was administered at a volume of 0.01 mg/g body weight per mouse for 14 days, and tumors were irradiated with 2.0 Gy on days 1 and 8. Mice treated with either radiation or S-1 alone were used as controls. The growth of tumors in each group was measured and, after completion of the treatment, a focused DNA array was used to determine mRNA expression levels in the tumors of 132 genes related to 5-fluorouracil (5-FU), radiation or carcinogenesis.. The additive antitumor effect of S-1 and radiation was statistically confirmed on day 14 (p=0.01). DNA array assay showed significant changes in expression of several genes, including DNA repair gene POLD, angiogenesis-related genes bFGF and TP, DNA topoisomerase TOP2A, and nucleoside transporter gene ENT1.

Topics: Administration, Oral; Animals; Antimetabolites, Antineoplastic; Combined Modality Therapy; Drug Combinations; Fluorouracil; Humans; Hypopharyngeal Neoplasms; Male; Mice; Mice, Nude; Oxonic Acid; Tegafur; Tumor Burden; Xenograft Model Antitumor Assays

We report a case of hypopharyngeal carcinoma with recurrent neck metastasis. Preoperative chemoradiation and pharyngo-laryngo-esophagectomy with bilateral neck dissection was done as first-line therapy. Six months later, the carcinoma metastasized to the right paratracheal lymph node. Because of resistance to chemoradiation (CBDCA) as second-line therapy, we administered TS-1 for the treatment after 60 Gy radiation. The chemotherapy with TS-1 resulted in complete response by diagnostic imaging (CT). There was no sign of recurrence for 1 year after 5 courses of treatment. TS-1, which allows oral chemotherapy on an outpatient basis, would be a useful drug for treatment with radiotherapy in patients with advanced and/or recurrent head and neck cancer.

Topics: Antimetabolites, Antineoplastic; Carcinoma, Squamous Cell; Drug Administration Schedule; Drug Combinations; Humans; Hypopharyngeal Neoplasms; Lymph Nodes; Lymphatic Metastasis; Male; Middle Aged; Neck; Oxonic Acid; Pyridines; Tegafur

The syndrome of inappropriate antidiuretic hormone secretion (SIADH) is characterized by hyponatremia and the plasma hypoosmolality induced by water retention attributable to persistent antidiuretic hormone (ADH) release. It has been reported that SIADH may occur due to various factors in patients with malignant tumor. We report a case of hypopharyngeal cancer complicated by SIADH following chemotherapy. A 72-year-old woman with hypopharyngeal cancer was treated by oral administration of S-1 and intravenous administration of low-dose cisplatin following radiation therapy. General fatigue and coma occurred during the third course of this chemotherapy, using S-1 and low-dose cisplatin. We believed that she had SIADH because of the results of examinations including hyponatremia, serum hypoosmolality and increasing serum ADH level. We treated her by fluid restriction and intravenous administration of hypertonic saline and furosemide, and she recovered. Unfortunately, her hypopharyngeal cancer gradually progressed and she died of acute pneumonia three months later.

Topics: Aged; Antimetabolites, Antineoplastic; Antineoplastic Agents; Carcinoma, Squamous Cell; Cisplatin; Drug Combinations; Fatal Outcome; Female; Humans; Hyponatremia; Hypopharyngeal Neoplasms; Inappropriate ADH Syndrome; Osmolar Concentration; Oxonic Acid; Pyridines; Radiotherapy, Adjuvant; Tegafur; Vasopressins