s-1-(combination) and Laryngeal-Neoplasms

To improve the outcomes of radiotherapy alone for T2 glottic carcinoma (GC), we initiated a prospective study of concurrent chemoradiotherapy with S-1 for patients with early GC, primarily T2 cases. We report the efficacy and safety of this protocol.. Eligible patients had T1b or T2 glottic squamous cell carcinomas. Patients received S-1 (55.3 mg/m(2)/day, once daily) and radiotherapy (2 Gy/day, five days/week, to a total of 30 fractions).. Thirteen patients were eligible. Complete responses were observed in all 13 patients (100%). At a median follow-up duration of 53 months (range=23-68 months), the 3-year local control and overall survival rates were both 100%. Grade 3 dermatitis occurred in only one patient.. This chemoradiotherapy protocol is well -tolerated and effective in patients with early glottic carcinoma. Furthermore, due to its once-daily administration, this protocol is considered to be easier than usual chemoradiotherapy, and makes outpatient-treatment possible.

Topics: Aged; Carcinoma, Squamous Cell; Chemoradiotherapy; Combined Modality Therapy; Drug Combinations; Female; Glottis; Head and Neck Neoplasms; Humans; Laryngeal Neoplasms; Male; Middle Aged; Oxonic Acid; Prospective Studies; Radiotherapy Dosage; Squamous Cell Carcinoma of Head and Neck; Survival Rate; Tegafur

The goals of treatment for head and neck cancer are cure and organ-function preservation. For organ preservation, primary treatment via radiotherapy alone is thought to be insufficient for Stage II squamous cell carcinoma of the larynx, oropharynx or hypopharynx. The objective of the present study was to investigate the efficacy and safety of concurrent chemoradiotherapy with S-1 for patients with Stage II squamous cell carcinoma of the pharynx or larynx for primary organ preservation.. Previously untreated patients with Stage II squamous cell carcinoma of the larynx, oropharynx or hypopharynx received three courses of S-1 (40 or 50 mg twice a day; 2 weeks of administration followed by 1 week of rest every 3 weeks) during conventional radiotherapy (a single daily fraction of 1.8 Gy) to a total dose of 70.2 Gy. The primary endpoint was the local control rate at 3 years.. From August 2009 to October 2012, 37 patients were evaluated for the study. The overall response rate was 100%. The 3-year local control rate was 89.0% (95% confidence interval, 78.9-99.2%), and the 3-year overall survival rate was 97.2% (95% confidence interval, 91.8-100%). Mucositis and dermatitis in the radiation field were the most common acute adverse events observed. The rates of Grade 3 mucositis and dermatitis were 27 and 35%, respectively. No patients experienced Grade 4 acute adverse events. The treatment completion rate was 89.2%.. Concurrent chemoradiotherapy with S-1 was safe and effective in improving local control for Stage II squamous cell carcinoma of the pharynx or larynx.

Topics: Aged; Antimetabolites, Antineoplastic; Carcinoma, Squamous Cell; Chemoradiotherapy; Drug Combinations; Female; Humans; Laryngeal Neoplasms; Male; Middle Aged; Neoplasm Staging; Oxonic Acid; Pharyngeal Neoplasms; Tegafur

A Phase I/II study of S-1 combined radiation therapy was conducted in patients with Stage II (T2N0) glottic cancer. The purpose of the Phase I study was to identify the maximum tolerated dose, the recommended dose and the dose limiting toxicity. The objectives in the phase II study were to estimate the local control and the overall survival, and the incidence of adverse events.. In Phase I, S-1 was administered orally in a split-course fashion as two doses of 40 mg/m(2), for a total daily dose of 80 mg/m(2). The course involved a 2-week rest after a 2-week administration (Level 1) and a 1-week rest after a 3-week administration (Level 2). Radiation therapy was administered in 2-Gy daily (total 60-Gy) standard fractionation.. Seven patients were enrolled in the Phase I, and 19 in the Phase II study. Mucositis was the most common toxicity encountered. All 26 patients completed radiation therapy without delay. The overall response rate was 100% (26/26) with all patients showing a complete response. One patient developed a local recurrence 28 months after the treatment. The 3-year local control and overall survival rates were 94.7 and 85.4%, respectively (limited to 22 patients from Level 2).. The use of S-1 at 80 mg/m(2) per day in a split-course with 1-week rest during the course of radiation therapy was safe and effective for Stage II glottic cancer. The treatment strategy employing orally available S-1 proved to be beneficial over the conventional injection of antitumor agents for maintaining the patients' quality of life.

Topics: Aged; Aged, 80 and over; Anemia; Carcinoma, Squamous Cell; Combined Modality Therapy; Drug Administration Schedule; Drug Combinations; Female; Follow-Up Studies; Glottis; Humans; Kaplan-Meier Estimate; Laryngeal Neoplasms; Male; Middle Aged; Nausea; Neutropenia; Oxonic Acid; Radiotherapy; Tegafur; Treatment Outcome

We conducted a phase I study to determine a recommended dose (RD) of S-1 for chemo-radiotherapy consisting of S-1+ radiotherapy for T 2 N 0 larynx cancer. The method of administration used to assess the RD was irradiation with 2 Gy/day for 5 days a week until a total dose of 60 Gy, and concomitant administration of S-1 once a day for 2 weeks beginning on the day therapy was started followed by 2 weeks off the drug and 2 weeks on the drug with the dose escalating from S-1 60 mg/body/day (level 1) to 80 mg/body/day (level 2), and then to 100 mg/body/day (level 3). 18 patients were enrolled. 4 patients developed an adverse event of grade 3 radiation dermatitis which became a dose-limiting toxicity (DLT) at level 3. We then concluded that 100 mg/body/day was the maximum tolerated dose (MTD) of S-1 and decided that the RD of S-1 was 80 mg/body/day.

Topics: Aged; Antimetabolites, Antineoplastic; Carcinoma, Squamous Cell; Combined Modality Therapy; Deglutition Disorders; Drug Administration Schedule; Drug Combinations; Female; Glottis; Humans; Laryngeal Neoplasms; Leukopenia; Male; Maximum Tolerated Dose; Middle Aged; Oxonic Acid; Radiation Injuries; Radiodermatitis; Radiotherapy Dosage; Stomatitis; Tegafur

Chemoradiation based on S-1, a novel oral antitumor agent of fluorinated pyrimidines, is the treatment for T2N0 glottic carcinoma; however, the optimal scheduling and dosing have still not been established. A phase I study was conducted to determine the maximum tolerated dose of S-1 with radiotherapy of 2 Gy/day for 5 days a week to a total dose of 60 Gy. Endpoints of this study were to examine the toxicity profile of this regimen and to determine the recommended dose of S-1.. Concomitant administration with the above-mentioned radiotherapy of S-1 once a day for 2 weeks, beginning on the day therapy was started, followed by 2 weeks off the drug and 2 weeks on the drug with the dose escalating from S-1 60 mg/body (level 1) to 80 mg/body/day (level 2), and then to 100 mg/body/day (level 3).. Twenty-one patients were valid for safety. Eighteen patients were enrolled in the dose-escalation phase. In all patients, S-1 was administered. The maximum tolerated dose was determined to be 100 mg/body/day and the dose-limiting toxicity was indicated by the onset of grade 3 chemoradiation dermatitis. Therefore, the determined recommended dose of S-1 was 80 mg/body/day. Objective response according to Response Evaluation Criteria in Solid Tumors were observed in 20 of 21 patients who had measurable disease (95.2%).. Concurrent S-1 and radiotherapy was feasible and well tolerated, and was suggested to produce a worthwhile response in T2N0 glottic carcinoma. These results warrant further investigation, and a phase II has already been started.

Topics: Adult; Aged; Dermatitis; Dose Fractionation, Radiation; Dose-Response Relationship, Drug; Drug Combinations; Feasibility Studies; Female; Glottis; Humans; Laryngeal Neoplasms; Male; Maximum Tolerated Dose; Middle Aged; Mucositis; Oxonic Acid; Tegafur; Treatment Outcome

This multicenter retrospective cohort study aimed to evaluate the significance of adding S-1 to radiotherapy (RT) for the treatment of T2N0 glottic cancer using a propensity score matched analysis in Japan.. This study was conducted on 287 patients with T2N0 glottic cancer who were treated with definitive RT or chemoradiotherapy with S-1 (S-1 RT) between April 2007 and March 2017. Propensity score matched analysis was performed to ensure the well-balanced characteristics of the groups of patients who received RT alone and S-1 RT. Overall, progression-free and laryngectomy-free survivals and local control and laryngeal preservation rates were compared.. Fifty-four pairs of patients were selected after performing propensity score matched analysis. Clinical characteristics were well-balanced between the two groups. The overall survival of patients in the S-1 RT group was significantly better than those in the RT alone group (P = 0.008). The progression-free and laryngectomy-free survivals of patients in the S-1 RT group were also better than those in the RT alone group; however, the differences were not significant. In contrast, patients in the S-1 RT group had slightly lower local control and laryngeal preservation rates compared with those in the RT alone group. The incidence of dermatitis in the S-1 RT group was significantly higher than that in the RT alone group in the matched population (P = 0.013).. The addition of S-1 to RT for the treatment of T2N0 glottic cancer was not associated with better local control and laryngeal preservation rates in this study.

Topics: Adult; Aged; Aged, 80 and over; Drug Combinations; Female; Glottis; Humans; Japan; Laryngeal Neoplasms; Male; Middle Aged; Oxonic Acid; Progression-Free Survival; Propensity Score; Retrospective Studies; 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

Background: The recommended treatment strategies for early glottic carcinoma with intent of larynx preservation are\ primarily radiotherapy. However, the outcomes of radiotherapy for bulky T1 or T2 glottic carcinoma are unsatisfactory.\ We designed a protocol consisting of concurrent chemoradiotherapy using S-1 as the radiosensitizer. We have performed\ this protocol in patients with favorable T2 lesions and demonstrated its efficacy and safety. In contrast, we have\ treated non-bulky T1 glottic carcinomas with 2.25 Gy per fraction, for a total of 25-28 fractions, starting in 2011 to\ improve efficacy and shorten the treatment period. Since this treatment strategy was implemented for T1 disease, no\ local failure has occurred to date, and it appears to be almost as safe as radiotherapy using 2.0 Gy per fraction. With\ the aim of improving the local control rate and shortening the treatment period primarily for favorable T2 disease, we\ changed the dose of radiation in our protocol from 2.0 Gy to 2.25 Gy per fraction, for a total of 25 fractions (from 30\ fractions). The present study aims to evaluate the efficacy and safety of this new protocol. Methods: This study will\ be conducted as a clinical, prospective, single-armed, non-randomized trial. Patients are to receive S-1 (55.3 mg /m2\ /day, once daily) and radiotherapy (2.25 Gy per fraction, for a total of 25 fractions). S-1 and radiotherapy are started\ on the same day that radiotherapy is performed, 3-6 hours after oral administration of S-1. The primary study aim is\ the 3-year local control rate. The secondary study aims are overall survival, voice-preservation survival, disease-free\ survival, complete response rate, completion rate, and toxicity. Result and conclusion: This is the first single-center,\ non-randomized, prospective study of concurrent chemoradiotherapy with S-1 and hypofractionated radiotherapy to\ be conducted. The trial will evaluate the efficacy and safety of our protocol.

Topics: Adult; Aged; Aged, 80 and over; Carcinoma, Squamous Cell; Chemoradiotherapy; Drug Combinations; Female; Follow-Up Studies; Glottis; Humans; Laryngeal Neoplasms; Male; Middle Aged; Outpatients; Oxonic Acid; Prognosis; Prospective Studies; Research Design; Survival Rate; Tegafur; Young Adult

In patients with head and neck cancer, the management of second primary cancer (SPC) is particularly important for improving survival because of its high incidence and associated mortality. We evaluated the impact of combination chemotherapy on survival and SPC.. We retrospectively analyzed data from 49 patients treated with definitive radiation therapy (RT) for T2N0M0 laryngeal squamous cell carcinoma between 2003 and 2011. Among them, 22 patients received combined modality treatment with radiotherapy and S-1 (RT+CT group).. The median follow-up period was 71months (32-111months). A significant difference in overall survival (OS, P<0.01) was observed between the RT+CT group (n=22) and the RT alone group (n=27) though no significant differences were observed in local control and disease specific survival. Univariate analyses showed that an older age (P<0.05) and a higher grade (P<0.05) were associated with OS. Multivariate analysis identified chemotherapy as the most significant predictor of survival (OR, 0.056; 95% CI, 0.008-0.353, P<0.01). A significantly lower incidence of distant metastasis (DM)+SPC (5-year incidence: 5% vs. 19%, P<0.05) and fewer deaths from these causes (1 vs. 8: P<0.05) were observed in the RT+CT group. Multivariate analysis showed that chemotherapy was the most significant factor for the incidence of DM+SPC (OR, 0.074; 95% CI, 0.0065-0.84; P<0.05).. The findings of this study suggest the possibility that combined modality treatment with radiotherapy and S-1 improve survival by preventing distant metastasis and second primary cancer.

Topics: Aged; Antimetabolites, Antineoplastic; Carcinoma, Squamous Cell; Chemoradiotherapy; Drug Combinations; Female; Humans; Laryngeal Neoplasms; Male; Middle Aged; Neoplasm Metastasis; Neoplasms, Second Primary; Oxonic Acid; Survival Analysis; Tegafur

We examined the completion rate, safety, and adverse events in patients with T2N0 glottic carcinoma who received chemoradiotherapy with S-1 (tegafur-gimeracil-oteracil potassium).. In T2N0 glottic carcinoma patients, we retrospectively compared the local control rate and outpatient therapy completion rate between 20 patients who received radiotherapy plus S-1 (S-1 group) and 20 who received radiotherapy alone (RT group).. Local recurrence was not detected in any of the 20 subjects from the S-1 group, whereas local recurrence was found in 4 of the 20 subjects (20%) from the RT group (p<0.05). Outpatient treatment was completed by 15 of the 20 subjects from the S-1 group and 17 of the 20 subjects from the RT group (p=0.43).. We investigated chemoradiotherapy with S-1 in patients who had T2N0 glottic carcinoma and found a higher local control rate when compared with radiotherapy alone as well as comparable safety for outpatient delivery.

Topics: Aged; Aged, 80 and over; Antimetabolites, Antineoplastic; Carcinoma; Chemoradiotherapy; Drug Combinations; Glottis; Humans; Laryngeal Neoplasms; Male; Middle Aged; Mucositis; Neoplasm Recurrence, Local; Neoplasm Staging; Oxonic Acid; Tegafur; Withholding Treatment

Radiation Therapy Oncology Group study 91-11 found that in resectable advanced laryngeal cancer, the locoregional control rate achieved with reduced intra-arterial cisplatin and concurrent radiotherapy (RADPLAT) was comparable to that of a concurrent chemoradiotherapy arm, with reduced toxicities. However, distant metastases were more frequent. Our study retrospectively evaluated the efficacy and feasibility of adjuvant chemotherapy with S-1, an oral fluoropyrimidine, for distant metastases following reduced RADPLAT.. We analyzed 61 patients who were treated with reduced RADPLAT and achieved a complete response at the primary site. After the use of reduced RADPLAT, 24 patients were administered S-1 for 2 weeks followed by 1 week of rest, and the cycle was repeated for 6 months (S-1+ group). Thirty-seven patients were not administered S-1 (S-1-group).. The hazard ratio for distant metastases in the S-1+ group was 0.114 (95% confidence interval, 0.015 to 0.881; p = 0.0374). There was a significant difference in disease-free survival in favor of the S-1+ group (p = 0.0455). Nineteen patients (79.2%) in the S-1+ group received S-1 according to the planned schedule and dose. Grade 3 toxicities were observed in 2 patients (8.3%), but there was no grade 4 event.. In resectable advanced laryngeal cancer, S-1 adjuvant chemotherapy is an effective and feasible treatment option to control distant metastases following reduced RADPLAT.

Topics: Administration, Oral; Aged; Antimetabolites, Antineoplastic; Carcinoma, Squamous Cell; Chemotherapy, Adjuvant; Cisplatin; Disease-Free Survival; Dose-Response Relationship, Drug; Drug Combinations; Feasibility Studies; Female; Humans; Laryngeal Neoplasms; Larynx; Male; Neoplasm Metastasis; Neoplasm Recurrence, Local; Organ Sparing Treatments; Oxonic Acid; Radiation-Sensitizing Agents; Radiotherapy Dosage; Radiotherapy, Adjuvant; Retrospective Studies; Tegafur

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

In this study, we evaluated the feasibility, efficacy and toxicity of concurrent chemoradiotherapy with S-1 (tegafur-gimeracil-oteracil potassium) for T2N0 glottic carcinoma. A total of 23 patients with T2N0 glottic carcinoma received chemoradiotherapy with S-1. Radiotherapy consisted of five daily fractions of 2 Gy per week, to a total median dose of 70 Gy. S-1 was administered 65 mg/m(2) per day for 4 weeks, beginning on the day therapy was started, followed by 2 weeks off the drug and twice a day until the end of radiotherapy. Initial local control rate of the primary tumor was achieved in all patients. The median follow-up period for all patients was 38 months. The 3-year local control rate was 95.4%. Regarding adverse reactions, grade 3 mucositis upon clinical examination, mucositis upon functional/symptomatic examination, dysphagia, hepatic toxicity and anemia were observed in 13, 2, 2, 1 and 1 patients, respectively. This chemoradiotherapy did not result in grade 4 acute toxicity or severe late toxicity. Chemoradiotherapy with S-1 was feasible, well tolerated and effective. This therapy is suggested as a possible regimen for improving local control of T2N0 glottic carcinoma.

Topics: Aged; Antineoplastic Combined Chemotherapy Protocols; Carcinoma, Squamous Cell; Combined Modality Therapy; Drug Combinations; Glottis; Humans; Kaplan-Meier Estimate; Laryngeal Neoplasms; Male; Middle Aged; Oxonic Acid; Pyridines; Radiation-Sensitizing Agents; Tegafur

Adverse events and therapeutic effects were analyzed in patients with pharyngeal or advanced laryngeal squamous cell carcinomas(SCCs)receiving concurrent chemoradiotherapy (CCRT) with S-1 or weekly CDDP between 2004 and 2007. Low-dose CDDP (25 mg/m2) was administered once a week and S-1 (65 mg/m2) was administered for 3 weeks with one-week rest during conventional radiation with 2 Gy/fraction. Both of the two CCRT regimens showed little toxicity with grade 4 toxicities in less than 5%of the patients. However, CCRT with S-1 more frequently induced grade 3 and 4 oral mucositis than CCRT with CDDP. As a result, the completion rate of CCRT with S-1 was lower than that of CCRT with CDDP. The two regimens achieved a similar complete response rate of the primary sites, local control rate(LCR)and larynx preservation rate; the LCR for T1 and 2 disease was more than 70%. However, the LCR for T3 or 4 disease by the two regimens was less than 50%. CCRT with S-1 showed significantly higher LCR in patients with poorly or undifferentiated SCCs than those with well or moderately-differentiated SCCs. It is suggested that the two CCRT regimens are useful treatment modalities for patients with locally(primary site)non-advanced pharyngeal or laryngeal SCCs, and that CCRT with S-1 is highly sensitive to poorly or undifferentiated SCCs. In order to achieve local control and larynx preservation, more intensive CCRT might be necessary for patients with locally(primary site)advanced pharyngeal or laryngeal SCCs.

Topics: Aged; Aged, 80 and over; Cisplatin; Combined Modality Therapy; Drug Combinations; Female; Humans; Laryngeal Neoplasms; Male; Middle Aged; Oxonic Acid; Pharyngeal Neoplasms; Survival Rate; 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

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

Early glottic carcinoma has a good prognosis compared to other head and neck carcinomas, but we must aim for larynx preservation in the treatment. Regarding T1N0, larynx preservation rates are favorable even with radiotherapy alone. However for T2N0, the treatment strategies differ in each institution, and larynx preservation rates range from 72% to 85%, and are not high enough. We conducted a study to determine the efficacy of the concurrent chemoradiotherapy with S-1 for T2N0 glottic carcinoma. In this study, 12 patients with T2N0 glottic type laryngeal squamous cell carcinoma enrolled from the year 2004 to 2006, received one reduction dose of S-1 (80 or 100 mg/day) with concomitant irradiation with a total dose of 60-70 Gy (2.0 Gy/fr). The 2-week administration of S-1 followed by one-week rest was repeated during irradiation. In terms of adverse events of Grade 3 and above, Grade 3 mucositis and dermatitis were found in 2 patients each, but there was no cancellation nor interruption of S-1 or irradiation. All patients achieved pathological CR at the time of evaluation after the primary treatment, and no recurrences have been seen yet in any of the primary sites. Concurrent chemoradiotherapy with S-1 showed efficacy in T2N0 glottis carcinoma. Further investigation of this treatment with long-term follow up results is warranted.

Topics: Adult; Aged; Antimetabolites, Antineoplastic; Carcinoma, Squamous Cell; Combined Modality Therapy; Drug Combinations; Glottis; Humans; Laryngeal Neoplasms; Male; Middle Aged; Oxonic Acid; Radiotherapy; Radiotherapy Dosage; Tegafur

We report two head and neck cancer patients who responded to TS-1. Case 1, a 52-year-old man was admitted to our department a diagnosis of supraglottic laryngeal cancer (T3N2cM0) on January 25, 2000. Concurrent chemoradiotherapy consisting of 2 courses of chemotherapy and radiation therapy at 70.2 Gy was administered. After the treatment, a biopsy showed a remaining cancer in the primary lesion. Since the patient refused to undergo surgery, the patient was followed up at the outpatient clinic using UFT at 400 mg/day. Because pulmonary metastasis was detected by chest CT, administration of TS-1 was started. TS-1 was administered at the conventional dose of 120 mg/day for 4 weeks followed by a 2-week rest. According to a CT conducted after 2 courses, the mass in the lung field disappeared and the clinical outcome was judged to be a CR. The TS-1 administration is still continuing, and the patient's condition also remains a CR. Case 2 was a patient with highly-differentiated adenocarcinoma in the ethmoid sinus (T3N2bM0). The patient was inoperable and was given radiation therapy of 64.8 Gy. Because of no change of the tumor after radiotherapy, TS-1 was administered at 60 mg x 2/day for 4 weeks followed by a 2-week rest. After TS-1 was administered for 3 courses, a CT showed a remarkable regression of the tumor resulting in a PR for the primary and the neck lesion. Upper gastrointestinal endoscopy during the 4th course detected a gastric ulcer of the A1 stage, and the patient was immediately admitted to the hospital. The ulcer was an adverse reaction of grade 3, which was improved by conservative therapy. TS-1 was restarted with a dose of 100 mg/day on April 11. No particular adverse reaction has been observed since then. The patient has received 13 courses of TS-1 and is still receiving TS-1. No clear tumor has been observed, and the clinical outcome is considered to be a CR. TS-1 is considered to be an excellent oral anticancer drug in terms of its anti-tumor effect and the patient's QOL.

Topics: Adenocarcinoma; Antimetabolites, Antineoplastic; Drug Administration Schedule; Drug Combinations; Head and Neck Neoplasms; Humans; Laryngeal Neoplasms; Lung Neoplasms; Male; Middle Aged; Oxonic Acid; Pyridines; Quality of Life; Remission Induction; Tegafur

A patient with advanced recurrent laryngeal cancer complicated with cervical lymph node metastasis was successfully treated with chemoradiotherapy with an oral anticancer drug, TS-1. TS-1 was administered at a dose of 120 mg/day. One course consisted of consecutive administration of TS-1 for 28 days and withdrawal for 14 days. During chemotherapy, the patient received concomitant radiotherapy (60 Gy). At the end of 2 courses, a partial response of the neck metastasis was achieved.

Topics: Antimetabolites, Antineoplastic; Drug Combinations; Humans; Laryngeal Neoplasms; Laryngectomy; Lymph Nodes; Lymphatic Metastasis; Male; Middle Aged; Oxonic Acid; Pyridines; Radiotherapy Dosage; Skin Neoplasms; Tegafur