Department of Oral Surgery, Oral Restitution, Division of Oral Health Sciences, Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan.
Cancer Chemother Pharmacol. 2013 Apr;71(4):1059-64. doi: 10.1007/s00280-013-2101-5. Epub 2013 Feb 3.
We evaluated whether preoperative chemotherapy with S-1 and concurrent radiotherapy is feasible and efficacious in the treatment of advanced oral squamous cell carcinoma.
Participants comprised 39 patients with oral carcinoma (stage III, n = 15; stage IVA, n = 24). All patients received a total radiation dose of 40 Gy, in once-daily 2-Gy fractions, and received S-1 at 65 mg/m(2)/day for 5 consecutive days, over 4 consecutive weeks with concurrent radiotherapy.
Hematological toxicity was mild and reversible. The most common non-hematological toxicity was grade 3 mucositis, but this was transient and tolerable. Radical surgery was performed for 37 patients, with the remaining 2 patients declining the surgery. Postoperatively, local failure developed in 1 patient, and neck failure in 2 patients. Distant metastases were identified in 4 patients. At a median follow-up of 38.0 months (range 23-88 months), locoregional control, disease-specific survival, and overall survival rates at 3 years were 91.5, 83.8, and 83.8 %, respectively.
Concurrent administration of S-1 and radiotherapy combined with surgery offers a well-tolerated method of successfully treating advanced oral squamous cell carcinoma. The locoregional control rate remains high even at 3 years of follow-up, and no serious adverse effects have been encountered.
我们评估 S-1 术前化疗联合放疗在治疗晚期口腔鳞状细胞癌中的可行性和疗效。
共纳入 39 例口腔癌患者（Ⅲ期 15 例，ⅣA 期 24 例）。所有患者接受总剂量 40 Gy 的放疗，1 天 1 次，每次 2 Gy，同时接受 S-1 治疗，剂量为 65 mg/m2/天，连续 5 天，每周连续 4 天。
血液学毒性较轻且可逆。最常见的非血液学毒性为 3 级黏膜炎，但为一过性，可耐受。37 例患者接受根治性手术，2 例患者拒绝手术。术后 1 例出现局部失败，2 例出现颈部失败。4 例患者出现远处转移。中位随访 38.0 个月（23-88 个月），3 年局部区域控制率、疾病特异性生存率和总生存率分别为 91.5%、83.8%和 83.8%。
S-1 同期放化疗联合手术为治疗晚期口腔鳞状细胞癌提供了一种耐受性良好的方法。即使在 3 年的随访中，局部区域控制率仍然较高，且未出现严重的不良反应。
