Ciência e terapia do câncer

Neoadjuvant Chemotherapy with S-1 for Patients with Oral Squamous Cell Carcinoma

Abstract

Hidetaka Yokoe, Atsushi Kasamatsu, Katsunori Ogawara, Takashi Ishigami, Yasunori Sato, Masashi Shiiba, Hideki Tanzawa and Katsuhiro Uzawa

S-1, an oral anticancer drug, is comprised of tegafur (a prodrug of 5-fluorouracil) and two biochemical modulators that have effect-enhancing and adverse reaction-reducing activities. Neoadjuvant chemotherapy (NAC) using S-1 has not been reported. Between April 2003 and March 2008, 103 patients with previously untreated oral squamous cell carcinoma (OSCC) received some courses of S-1 NAC (S-1 80 mg/m2/day as the NAC until 1 week preoperatively). Tumor size and histopathologic effect were evaluated before and after treatment. Among 103 cases, 10 cases had complete responses and 53 cases had partial responses (overall response rate [RR], 61.2%). Twenty-two (21.4%) patients had adverse events. Most patients had mild toxicities in the bone marrow and digestive tract (grade 1, 19 cases). Only three patients (2.9%) had grade 2 neutropenia or grade 4 thrombocytopenia. We examined the relationship between the RR and the clinicopathologic behaviors. The RR of the pN2 cases (33.3%) was significantly lower than that of the pN0 cases (69.4%). The RR was not correlated with tumor size, differentiation type, distant metastasis, and the period of administration. The data indicates that S-1 caused only mild toxicity and had highly effective antitumor activity. Furthermore, the RR of S-1 NAC might predict regional lymph node metastasis.