Two elderly patients with advanced maxillary gingival carcinoma with complete response to concurrent radiotherapy and S-1 chemotherapy

Abstract

Abbreviations: OSCC, oral squamous cell carcinoma; CR, complete response; BSA, body 2 surface area; RECIST, response evaluation criteria in solid tumors; CTCAE v3.0, common terminology criteria for Adverse Events version 3.0; ADL, activities of daily living.3 Abstract: The use of the novel oral fluoropyrimidine anticancer drug S-1 as a single-agent or in combined chemotherapy has been reported to be useful for the treatment of advanced oral cancer.We report two elderly patients with advanced oral cancer who achieved complete response (CR) after concurrent radiotherapy and S-1 chemotherapy. Patient 1 was an 81-year-old woman who had a 50 × 40 mm tumor erosion in the right upper gingival region. At 2.5 years after the end of concurrent radiotherapy and S-1 chemotherapy, tumor relapse was observed, although CR continued temporarily. The patient died 3 years after the end of concurrent radiotherapy and S-1 chemotherapy due to tumor relapse and high blood pressure resulting in deterioration of patient condition. Patient 2 was an 89-year-old woman who had a 40 × 30 mm tumor ulcer in the right gingiva. Neither relapse nor metastasis was seen, and patient condition remained good for the 3 years after concurrent radiotherapy and S-1 chemotherapy. In both patients, MRI showed that the tumor had deeply invaded the palatal bone, almost reaching the nasal cavity, with metastasis 4 to the right upper superior internal jugular nodes. In both patients, biopsy showed a well-differentiated squamous cell carcinoma. Concurrent radiotherapy and S-1 chemotherapy induced CR without severe adverse effects.

Concurrent chemoradiotherapy with S-1 in patients with stage III–IV oral squamous cell carcinoma: A retrospective analysis of nodal classification based on the neck node level

“…The pathological effects of preoperative CCRT with S-1 have been demonstrated in operated patients with advanced oral SCC (4,5). Some case reports suggest the possible efficacy of definitive CCRT with S-1 (6). However, further investigations are required to evaluate the treatment outcomes of CCRT with S-1 for inoperable advanced oral SCC.…”

“…Advanced oral squamous cell carcinoma (SCC) is commonly treated by combined surgery, radiotherapy and chemotherapy; patients with unresectable disease usually undergo concurrent chemoradiotherapy (CCRT) (1)(2)(3)(4)(5)(6)(7). Although CCRT is considered to be superior to radiotherapy alone in improving survival, it may not be suitable for elderly patients and/or those with poor performance status (7).…”