Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
J Radiat Res. 2011;52(1):47-53. doi: 10.1269/jrr.10081. Epub 2010 Dec 24.
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.
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/m(2)/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.
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.
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.
S-1 是一种口服氟嘧啶类药物。本研究旨在回顾 S-1 联合放疗治疗口咽癌患者的临床结果。
2002 年至 2007 年间，回顾了 38 例接受 S-1 联合根治性放疗的口咽癌患者。临床分期为 I 期 4 例，Ⅱ期 7 例，Ⅲ期 7 例，Ⅳ期 20 例。S-1 口服，每日 2 次，连续 4 周，然后停药 2 周。S-1 的初始剂量为 65mg/m²/天。所有患者均采用三维适形放疗，中位总剂量为 65.1Gy（范围 60.0-71.0Gy）。根据病历和临床随访，分析临床结果和主要急性毒性。
中位随访时间为 33 个月，所有患者的 3 年局部区域控制、远处转移无进展生存、无病生存和总生存估计值分别为 75%、80%、65%和 80%。根据分期，Ⅰ期和Ⅱ期的 3 年局部区域控制估计值为 100%，Ⅲ期为 86%，Ⅳ期为 56%。≥3 级急性黏膜炎发生率为 32%，≥3 级血液学毒性发生率为 8%。未观察到其他严重毒性。
S-1 同期放化疗疗效确切，尤其适用于早期疾病。治疗相关毒性可接受，骨髓抑制发生率低。必须进行进一步研究，以与其他化疗方案进行比较。
