Concurrent Chemoradiotherapy with S-1 as First-line Treatment for Patients with Oropharyngeal Cancer

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  • OHNISHI Kayoko
    Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University
  • SHIOYAMA Yoshiyuki
    Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University
  • NAKAMURA Katsumasa
    Department of Radiology, Kyushu University Hospital at Beppu
  • NAKASHIMA Torahiko
    Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University
  • OHGA Saiji
    Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University
  • NONOSHITA Takeshi
    Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University
  • YOSHITAKE Tadamasa
    Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University
  • TERASHIMA Kotarou
    Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University
  • KOMUNE Shizuo
    Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University
  • HONDA Hiroshi
    Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University

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Purpose: S-1 is an oral fluoropyrimidine. The purpose of this study was to review the clinical outcomes of S-1 with concurrent radiotherapy for patients with oropharyngeal cancer. Materials and Methods: Between 2002 and 2007, 38 patients with oropharyngeal cancer treated concurrently with S-1 and definitive radiotherapy were reviewed. The clinical stage was Stage I in 4 patients, Stage II in 7, Stage III in 7, and Stage IV in 20. S-1 was administered orally twice daily for 4 consecutive weeks followed by a 2-week drug withdrawal. The initial dose of S-1 was 65 mg/m2/day. All patients were treated using three-dimensional conformal radiotherapy with a median total dose of 65.1 Gy (range, 60.0–71.0 Gy). Clinical outcomes and major acute toxicities were analyzed based on medical records and clinical follow-up. Results: With a median follow-up time of 33 months, the 3-year estimates of local-regional control, distant metastases-free survival, disease-free survival, and overall survival for all patients were 75%, 80%, 65%, and 80%, respectively. The 3-year estimates of local-regional control according to stage were 100% for Stages I and II, 86% for Stage III, and 56% for Stage IV. The rate of ≥ Grade 3 acute mucositis was 32%, and the rate of ≥ Grade 3 hematological toxicities was 8%. No other severe toxicities were observed. Conclusions: Concurrent chemoradiotherapy with S-1 was found to be effective, especially for early disease. The treatment-related toxicities were acceptable, and the incidence of myelotoxicity was low. Further study must be carried out to compare with other chemotherapy regimens.

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