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Induction chemotherapy with S-1 plus cisplatin in patients with locally advanced squamous cell carcinoma of the head and neck

Published online by Cambridge University Press:  30 November 2007

Y J Choi*
Affiliation:
Department of Hemato-oncology, Pusan National University Hospital, Busan, Republic Of Korea
J S Chung
Affiliation:
Department of Hemato-oncology, Pusan National University Hospital, Busan, Republic Of Korea
H-J Shin
Affiliation:
Department of Hemato-oncology, Pusan National University Hospital, Busan, Republic Of Korea
G J Cho
Affiliation:
Department of Hemato-oncology, Pusan National University Hospital, Busan, Republic Of Korea
S G Wang
Affiliation:
Department of Otolaryngology, Pusan National University Hospital, Busan, Republic Of Korea
B J Lee
Affiliation:
Department of Otolaryngology, Pusan National University Hospital, Busan, Republic Of Korea
B M Cho
Affiliation:
Department of Preventive Medicine, Pusan National University Hospital, Busan, Republic Of Korea
Y D Joo
Affiliation:
Department of Hemato-oncology, Inje University Hospital, Busan, Republic of Korea
C H Sohn
Affiliation:
Department of Hemato-oncology, Inje University Hospital, Busan, Republic of Korea
*
Address for correspondence: Professor Jooseop Chung, Department of Hematology-oncology, Pusan National University Hospital, 1-10 Ami-Dong, Seo-Gu, Busan 602-739, South Korea. Fax: 82 51 254 3127 E-mail: porori701@hanmail.net

Abstract

Objective:

This study was performed to assess the efficacy and safety profile of combination treatment with S-1 and cisplatin in patients with locally advanced squamous cell carcinoma of the head and neck.

Design:

Eligibility criteria comprised: histologically confirmed squamous cell carcinoma of the head and neck; stage three or four disease with no evidence of distant metastasis; evaluable lesions; adequate organ function; age 20–80 years; and a performance status of two or less. Cisplatin was infused over one hour on day one (75 mg/m2) and S-1 was administered orally for 14 consecutive days (days two to 15). The dosages of S-1 were calculated according to the patients' body surface area: 50 mg twice a day (body surface area <1.5 m2) or 60 mg twice a day (body surface area >1.5 m2). Each course was repeated every three weeks. After two courses, tumour response was evaluated by computed tomography and laryngoscopy. If a response was evident (either complete or partial), the patient received one more course of chemotherapy, before undergoing radical treatment such as radiotherapy or surgery.

Results:

All 30 patients were assessable for toxicity, and 29 patients for treatment response. The overall response was 89.7 per cent (complete response: nine; partial response: 17). The two-year estimated overall survival rate was 79.2 per cent. Adverse reactions occurred 128 times during 81 courses in the 30 cases. The most common grade three to four adverse event was neutropenia, which occurred in eight patients. Cases of non-haematological grade three or four toxicity included nausea and vomiting in four patients, stomatitis in two and diarrhoea in one.

Conclusion:

S-1 plus cisplatin combination chemotherapy is effective against locally advanced squamous cell carcinoma of the head and neck, with only mild toxicity.

Type
Main Article
Copyright
Copyright © JLO (1984) Limited 2007

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