Analysis of feasibility and toxicity of concurrent chemoradiotherapy with S-1 for locally advanced squamous cell carcinoma of the head and neck in elderly cases and/or cases with comorbidity.
OBJECTIVE
The aim of this study was to evaluate the feasibility and toxicity of concurrent chemoradiotherapy (CCRT) with S-1 in patients with locally advanced squamous cell carcinoma of the head and neck (SCCHN) in elderly cases and/or cases with comorbidity.


METHODS
Fifty eligible patients with stage III (15 cases) or stage IV (35 cases) SCCHN were treated with CCRT. Thirteen cases had an advanced age of over 75 years and 37 cases had comorbidity. Definitive radiotherapy was delivered up to a total dose of 66-70.2 Gy. The patients received two courses of oral S-1 (40 or 50 mg twice a day [80 or 100 mg/day]) for 2 weeks followed by 1 week of rest while receiving CCRT.


RESULTS
All the patients received the planned radiotherapy and at least one course of S-1. Grade 3 mucositis occurred in 20% of the patients (10/50). Grade 3 neutropenia occurred in 12% (6/50) and leukocytopenia occurred in 6% (3/50) of the cases. Pathologically, the complete response rates were 93% in stage III and 54% in stage IV.


CONCLUSIONS
Concurrent chemoradiotherapy with S-1 is a safe, well-tolerated and effective regimen for locally advanced SCCHN in elderly cases and/or cases with comorbidity.
Tsukuda
Mamoru
M
Department of Otorhinolaryngology, and Head and Neck Surgery, Yokohama City University School of Medicine, Yokohama, Japan. mtsukuda@med.yokohama-cu.ac.jp
Ishitoya
Junichi
J
Mikami
Yasukazu
Y
Matsuda
Hideki
H
Horiuchi
Choichi
C
Taguchi
Takahide
T
Satake
Kenichi
K
Kawano
Toshiro
T
Takahashi
Masahiro
M
Nishimura
Goshi
G
Kawakami
Mariko
M
Sakuma
Yasunori
Y
Watanabe
Makiko
M
Shiono
Osamu
O
Komatsu
Masanori
M
Yamashita
Yukiko
Y
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000964:Antimetabolites, Antineoplastic / Q000009:adverse effects / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000601:surgery / Q000628:therapy*; D003131:Combined Modality Therapy; D004338:Drug Combinations; D005260:Female; D006258:Head and Neck Neoplasms / Q000150:complications / Q000601:surgery / Q000628:therapy*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010094:Oxonic Acid / Q000009:adverse effects / Q000627:therapeutic use*; D016019:Survival Analysis; D005641:Tegafur / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
D000964:Antimetabolites, Antineoplastic; D004338:Drug Combinations; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid