内容紹介
Summary
Background: In our department, patients with oral squamous cell carcinoma(OSCC)received preoperative chemotherapy containing S-1 to prevent the growth and dissemination of tumors during the waiting time before definitive surgery. We retrospectively evaluated the usefulness of this treatment. Patients and methods: One hundred and five patients comprising stages T1(26), T2(64), T3(7), and T4(8 cases)were enrolled in this study from July 2001 to June 2013. In principle, patients were administered S-1(80 mg/m2/day, days 1-14)and followed by a drug holiday(days 15-21), continuing until 1 week before surgery. Results: The median administration period was 14 days(256 days). Ninety-eight patients underwent definitive surgery, but 7 patients who revealed clinical CR underwent only biopsy and showed histological CR. The histological responses of all patients were CR(24), PR(22), and NC(59), and the response rate was 43.8%. Almost all adverse effects were Grade 1 or 2, except 1 case of neutropenia(Grade 3)and 1 case of urticaria(Grade 3). The 5-year overall survival rates were 86.7% in all cases, 95.3% in CR/PR cases, and 79.7% in NC cases. Conclusion: Preoperative S-1 administration during the waiting time was a safe and very effective method and was considered beneficial for patients with OSCC.
要旨
背景と目的: 当科では口腔癌の生検後から手術までの待機期間を利用しS-1による化学療法を行ってきたが,その有用性について後方視的に検討した。対象と方法: 2001年7月～2013年6月までの間に術前にS-1を投与した口腔扁平上皮癌患者105例で,S-1の投与は80～120 mg/日を2週間投与後1週間休薬する投与法を基本とし予定手術の1週間前まで行い,この時点で臨床的抗腫瘍効果の判断をRECISTガイドラインに基づいて行った。結果: 投与期間は2～56(中央値14)日であった。予定手術は98例(93.3%)に実施し,臨床的にCRが得られた患者のうち7例は手術を行わず生検のみにとどめた。これらの生検例はすべて組織学的CRであった。組織学的効果は,CR/PR/NCが24/22/59例で,奏効率は43.8%であった。Grade 3の有害事象は白血球減少1例(1%),皮疹が1例(1%)にみられたが,ほとんどの有害事象はGrade 2以下であった。Kaplan-Meier法による5年累積生存率は86.7%で,組織学的CR/PR例95.3%,NC例では79.7%であった。結語: 待機期間を利用したS-1の術前投与は安全性と有効性において優れており,手術待機期間を利用したS-1の投与は有益性が高いと考える。
目次
Background: In our department, patients with oral squamous cell carcinoma(OSCC)received preoperative chemotherapy containing S-1 to prevent the growth and dissemination of tumors during the waiting time before definitive surgery. We retrospectively evaluated the usefulness of this treatment. Patients and methods: One hundred and five patients comprising stages T1(26), T2(64), T3(7), and T4(8 cases)were enrolled in this study from July 2001 to June 2013. In principle, patients were administered S-1(80 mg/m2/day, days 1-14)and followed by a drug holiday(days 15-21), continuing until 1 week before surgery. Results: The median administration period was 14 days(256 days). Ninety-eight patients underwent definitive surgery, but 7 patients who revealed clinical CR underwent only biopsy and showed histological CR. The histological responses of all patients were CR(24), PR(22), and NC(59), and the response rate was 43.8%. Almost all adverse effects were Grade 1 or 2, except 1 case of neutropenia(Grade 3)and 1 case of urticaria(Grade 3). The 5-year overall survival rates were 86.7% in all cases, 95.3% in CR/PR cases, and 79.7% in NC cases. Conclusion: Preoperative S-1 administration during the waiting time was a safe and very effective method and was considered beneficial for patients with OSCC.
要旨
背景と目的: 当科では口腔癌の生検後から手術までの待機期間を利用しS-1による化学療法を行ってきたが,その有用性について後方視的に検討した。対象と方法: 2001年7月～2013年6月までの間に術前にS-1を投与した口腔扁平上皮癌患者105例で,S-1の投与は80～120 mg/日を2週間投与後1週間休薬する投与法を基本とし予定手術の1週間前まで行い,この時点で臨床的抗腫瘍効果の判断をRECISTガイドラインに基づいて行った。結果: 投与期間は2～56(中央値14)日であった。予定手術は98例(93.3%)に実施し,臨床的にCRが得られた患者のうち7例は手術を行わず生検のみにとどめた。これらの生検例はすべて組織学的CRであった。組織学的効果は,CR/PR/NCが24/22/59例で,奏効率は43.8%であった。Grade 3の有害事象は白血球減少1例(1%),皮疹が1例(1%)にみられたが,ほとんどの有害事象はGrade 2以下であった。Kaplan-Meier法による5年累積生存率は86.7%で,組織学的CR/PR例95.3%,NC例では79.7%であった。結語: 待機期間を利用したS-1の術前投与は安全性と有効性において優れており,手術待機期間を利用したS-1の投与は有益性が高いと考える。