Division of Medical Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seodaemun-gu, Seoul, South Korea.
Cancer Chemother Pharmacol. 2012 Oct;70(4):539-46. doi: 10.1007/s00280-012-1933-8. Epub 2012 Aug 7.
To assess the clinical activity and toxicity of a combination chemotherapy regimen of S-1 and cisplatin in patients with recurrent and/or metastatic head and neck squamous cell carcinoma (HNSCC) in a retrospective study.
A total of 49 patients were treated in an outpatient setting with S-1 80 mg/m(2) on days 1-14 and with cisplatin 70 mg/m(2) on day 1 every 3 weeks for a maximum of six cycles as a first-line palliative chemotherapy. Patients who achieved complete response (CR), partial response (PR) or stable disease (SD) after six cycles received S-1 monotherapy as a maintenance therapy.
The median patient age was 55 years (range 33-79), 89.8 % were male, and the Eastern Cooperative Oncology Group performance status distribution was 0/1/2 (20.4 %/73.5 %/6.1 %). Of the 43 evaluable patients, 2 (4.1 %) achieved CR and 20 (40.8 %) had a PR, for an overall response rate of 44.9 %. Thirteen patients (26.6 %) had SD. The median number of chemotherapy treatments was 4 (range 1-18). Nine patients received maintenance S-1 monotherapy after six cycles of combination chemotherapy. With a mean 10.5 months (range 1.3-25.1) of follow-up, the median progression-free and overall survival were 4.5 (95 % CI, 3.7-5.3 months) and 10.8 months (95 % CI, 5.9-15.6 months), respectively. The main grade 3-4 toxicities were neutropenia (37 %), anemia (16 %) and general weakness (8 %). Other toxicities, including nausea/vomiting, mucositis and neuropathy, were mostly grade 1-2 and easily manageable.
The combination of S-1/cisplatin therapy had a favorable efficacy with manageable toxicity as a first-line chemotherapy regimen for advanced head and neck squamous cell carcinoma patients.
在一项回顾性研究中，评估 S-1 联合顺铂化疗方案治疗复发性和/或转移性头颈部鳞状细胞癌（HNSCC）患者的临床疗效和毒性。
共 49 例患者在门诊接受 S-1 80mg/m2，第 1-14 天；顺铂 70mg/m2，第 1 天，每 3 周为一个周期，最多 6 个周期，作为一线姑息化疗。完成 6 个周期后，完全缓解（CR）、部分缓解（PR）或稳定（SD）的患者接受 S-1 单药维持治疗。
中位患者年龄为 55 岁（范围 33-79），89.8%为男性，东部肿瘤协作组体力状况分布为 0/1/2（20.4%/73.5%/6.1%）。43 例可评价患者中，2 例（4.1%）达到 CR，20 例（40.8%）达到 PR，总有效率为 44.9%。13 例（26.6%）患者 SD。化疗次数中位数为 4（范围 1-18）。9 例患者在联合化疗 6 个周期后接受 S-1 单药维持治疗。中位随访 10.5 个月（范围 1.3-25.1），中位无进展生存期和总生存期分别为 4.5（95%CI，3.7-5.3）和 10.8 个月（95%CI，5.9-15.6）。主要的 3-4 级毒性为中性粒细胞减少（37%）、贫血（16%）和全身乏力（8%）。其他毒性，包括恶心/呕吐、黏膜炎和神经病变，大多为 1-2 级，易于处理。
S-1/顺铂联合治疗作为晚期头颈部鳞状细胞癌患者的一线化疗方案，疗效良好，毒性可耐受。
