title: Chemoradiation therapy with S-1 for primary squamous cell carcinoma of the rectum: report of three cases.
abstract: OBJECTIVE
  Although successful treatment of squamous cell carcinoma (SCC) of the rectum using chemoradiation therapy (CRT) has been reported, a standard protocol has yet to be established. The aim is to ascertain the effectiveness of CRT with S-1 for three patients with SCC of the rectum.
  
  
  METHODS
  We treated three female patients complaining of rectal bleeding. The patients were diagnosed as having primary SCC of the rectum by means of routine examinations; one of them was a very rare case because of the presence of two lesions in the lower rectum. We treated the patients using CRT with S1 at a radiation dose of 1.8 Gy/fraction given five times weekly (Monday to Friday) to a median dose of 59.4 (45 to 59.4) Gy; S-1 (80 mg/m(2)/day) was administered orally during radiation therapy. One of three patients had an adverse event involving massive hemorrhage from the tumor. All patients exhibited an excellent response to CRT with S-1; two patients had a complete response, and one patient had a partial response and underwent a posterior pelvic exenteration with advancement flap reconstruction as a salvage treatment. Pathological examination of the resected specimen and lymph nodes revealed no tumor cells indicating a pathological complete response. In this series, the response rate was 100%.
  
  
  CONCLUSIONS
  We suggest that CRT with S-1 be chosen as the first-line therapy for SCC of the rectum. However, a large study will be required to establish a safe and effective regimen.
authors.affiliation: Department of General and Gastroenterological Surgery, Toho University Medical Center, Omori Hospital, 6-11-1 Omorinishi, Otaku, Tokyo, 143-8541, Japan. kingkong@med.toho-u.ac.jp.
authors.forename: Kimihiko
authors.initials: K
authors.lastname: Funahashi
authors.affiliation: Department of Pathology, Toho University Medical Center, Omori Hospital, 6-11-1 Omorinishi, Otaku, Tokyo, 143-8541, Japan. tetsuo.nemoto@med.toho-u.ac.jp.
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Nemoto
authors.affiliation: Department of General and Gastroenterological Surgery, Toho University Medical Center, Omori Hospital, 6-11-1 Omorinishi, Otaku, Tokyo, 143-8541, Japan. jkoike18@med.toho-u.ac.jp.
authors.forename: Junichi
authors.initials: J
authors.lastname: Koike
authors.affiliation: Department of General and Gastroenterological Surgery, Toho University Medical Center, Omori Hospital, 6-11-1 Omorinishi, Otaku, Tokyo, 143-8541, Japan. akiharuhemo@med.toho-u.ac.jp.
authors.forename: Akiharu
authors.initials: A
authors.lastname: Kurihara
authors.affiliation: Department of General and Gastroenterological Surgery, Toho University Medical Center, Omori Hospital, 6-11-1 Omorinishi, Otaku, Tokyo, 143-8541, Japan. shiochan@med.toho-u.ac.jp.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Shiokawa
authors.affiliation: Department of General and Gastroenterological Surgery, Toho University Medical Center, Omori Hospital, 6-11-1 Omorinishi, Otaku, Tokyo, 143-8541, Japan. ushisan@med.toho-u.ac.jp.
authors.forename: Mistunori
authors.initials: M
authors.lastname: Ushigome
authors.affiliation: Department of General and Gastroenterological Surgery, Toho University Medical Center, Omori Hospital, 6-11-1 Omorinishi, Otaku, Tokyo, 143-8541, Japan. tomoaki.kaneko@med.toho-u.ac.jp.
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Kaneko
authors.affiliation: Department of General and Gastroenterological Surgery, Toho University Medical Center, Omori Hospital, 6-11-1 Omorinishi, Otaku, Tokyo, 143-8541, Japan. kenichirou.arai@med.toho-u.ac.jp.
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Arai
authors.affiliation: Department of General and Gastroenterological Surgery, Toho University Medical Center, Omori Hospital, 6-11-1 Omorinishi, Otaku, Tokyo, 143-8541, Japan. yasuo.nagashima@med.toho-u.ac.jp.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Nagashima
authors.affiliation: Department of General and Gastroenterological Surgery, Toho University Medical Center, Omori Hospital, 6-11-1 Omorinishi, Otaku, Tokyo, 143-8541, Japan. takamaru.kouda@med.toho-u.ac.jp.
authors.forename: Takamaru
authors.initials: T
authors.lastname: Koda
authors.affiliation: Department of General and Gastroenterological Surgery, Toho University Medical Center, Omori Hospital, 6-11-1 Omorinishi, Otaku, Tokyo, 143-8541, Japan. takayuki.suzuki@med.toho-u.ac.jp.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Suzuki
authors.affiliation: Department of General and Gastroenterological Surgery, Toho University Medical Center, Omori Hospital, 6-11-1 Omorinishi, Otaku, Tokyo, 143-8541, Japan. satoru.kagami@med.toho-u.ac.jp.
authors.forename: Satoru
authors.initials: S
authors.lastname: Kagami
authors.affiliation: Department of General and Gastroenterological Surgery, Toho University Medical Center, Omori Hospital, 6-11-1 Omorinishi, Otaku, Tokyo, 143-8541, Japan. yu0412yu@gmail.com.
authors.forename: Yu
authors.initials: Y
authors.lastname: Suitsu
authors.affiliation: Department of General and Gastroenterological Surgery, Toho University Medical Center, Omori Hospital, 6-11-1 Omorinishi, Otaku, Tokyo, 143-8541, Japan. hironori@med.toho-u.ac.jp.
authors.forename: Hironori
authors.initials: H
authors.lastname: Kaneko
authors.affiliation: Department of Pathology, Toho University Medical Center, Omori Hospital, 6-11-1 Omorinishi, Otaku, Tokyo, 143-8541, Japan. kaz@med.toho-u.ac.jp.
authors.forename: Toshikazu
authors.initials: T
authors.lastname: Shibuya
keywords: Chemoradiation therapy; Rectum; S-1; Squamous cell carcinoma