Concurrent Chemoradiotherapy with Pirarubicin and 5-fluorouracil for Resectable Oral and Maxillary Carcinoma

Iguchi, Hiroyoshi; Kusuki, Makoto; Nakamura, Aki; Nishiura, Hiroshi; Kanazawa, Akimori; Takayama, Masahiro; Sunami, Kishiko; Yamane, Hideo

doi:10.1080/03655230410018354

Cited by 10 publications

(5 citation statements)

References 12 publications

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“…Many studies have demonstrated that combined chemotherapy and radiation is a highly effective treatment modality for increasing the survival of patients with advanced disease [2,3,9-11]. Concurrent chemoradiotherapy has been established as an appropriate standard for many patients with locally advanced head and neck cancer.…”

Section: Discussionmentioning

confidence: 99%

“…Tsukuda et al reported that the complete response rate were 93% in stage III and 54% in stage IV, by treating head and neck cancer with S-1 and radiotherapy at a total dose of 66-70.2 Gy [14]. There have been few reports on the effect of preoperative chemoradiotherapy with a total radiation dose of 40-Gy [2,3]. …”

Section: Discussionmentioning

confidence: 99%

“…Iguchi et al reported an overall response rate of 100% when treating oral and maxillary carcinoma with concurrent chemoradiotherapy, using a combination of intraarterial pirarubicin, intravenous continuous 5-fluorouracil (5-FU), and a radiation dose of 40-Gy [3]. They concluded that their concurrent chemotherapy regimen is effective as a preoperative modality, with a remarkably high response rate and an acceptable level of adverse events.…”

Section: Introductionmentioning

confidence: 99%

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Preoperative concurrent chemotherapy with S-1 and radiotherapy for locally advanced squamous cell carcinoma of the oral cavity: Phase I trial

Harada

Omura

2010

J Exp Clin Cancer Res

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BackgroundThis study was conducted to identify a recommended dose for S-1, used in combination with 40-Gy radiation.MethodsThirty patients, 15 each with stage III and IVA oral carcinoma, were enrolled. All patients received a total dose of 40-Gy. For the S-1 treatment, patients were given either the standard Japanese dose, calculated according to body surface area, or a reduced dose. Groups consisting of at least three patients were given S-1 according to one of 8 regimens.ResultsHematologic toxicity was mild and reversible. The most common nonhematologic toxicity was mucositis. At level 8 that was the standard S-1 dose for 5 days per week for 4 weeks, dose-limiting toxicity was observed when 2 patients had grade 4 mucositis. This level was thus deemed the maximum tolerated dose for the regimen.ConclusionsThe recommended dose of S-1 with concurrent radiotherapy was the reduced dose of S-1 given for 5 days per week, for 4 consecutive weeks. Preoperative S-1 and concurrent radiotherapy was well tolerate and feasible and warrants a phase II study.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Preoperative concurrent chemotherapy with S-1 and radiotherapy for locally advanced squamous cell carcinoma of the oral cavity: Phase I trial

Harada

Omura

2010

J Exp Clin Cancer Res

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“…Mücke et al also demonstrated the efficacy of low-dose radiotherapy (total dose, 20 Gy) combined with concurrent low-dose cisplatin (12.5 mg/m 2 ) for 5 days, as pre-operative therapy (24). However, Iguchi et al reported the use of combined intra-arterial pirarubicin and continuous intravenous 5-fluorouracil (5-FU) with a radiation dose of 40 Gy (25). This study concluded that these regimens were effective as a pre-operative treatment, with a notably high response rate and an acceptable incidence of adverse events.…”

Section: Histopathological Response N ------------------------------mentioning

confidence: 99%

Clinicopathological evaluation of pre-operative chemoradiotherapy with S-1 as a treatment for locally advanced oral squamous cell carcinoma

et al. 2016

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Abstract. The administration of pre-operative chemotherapy with S-1 and concurrent radiotherapy at a total dose of 30 Gy was clinicopathologically evaluated as a treatment for locally advanced oral squamous cell carcinoma (OSCC) in the present study. The participants comprised 81 patients with OSCC, consisting of 29 patients with stage II disease, 12 patients with stage III disease and 40 patients with stage IV disease. All patients received a total radiation dose of 30 Gy in daily fractions of 2 Gy, 5 times a week, for 3 weeks, and the patients were concurrently administered S-1 at a dose of 80-120 mg, twice daily, over 4 consecutive weeks. Radical surgery was performed in all cases at 2-6 weeks subsequent to the end of pre-operative chemoradiotherapy. The most common adverse event was oropharyngeal mucositis, but this was transient in all patients. No severe hematological or non-hematological toxicities were observed. The clinical and histopathological response rates were 70.4 and 75.3%, respectively. Post-operatively, local failure developed in 6 patients (7.4%) and neck failure developed in 2 patients (2.5%). Distant metastases were found in 7 patients (8.6%). The overall survival rate, disease-specific survival rate and locoregional control rate at 5 years were 87.7, 89.9 and 90.6%, respectively. Locoregional recurrence occurred more frequently in patients that demonstrated a poor histopathological response compared with patients that demonstrated a good response (P<0.01). These results indicate that pre-operative S-1 chemotherapy with radiotherapy at a total dose of 30 Gy is feasible and effective for patients with locally advanced OSCC, and that little or no histopathological response may be a risk factor for locoregional recurrence in this treatment. IntroductionOral squamous cell carcinoma (OSCC) accounts for ~3% of all malignancies worldwide (1). Despite this low frequency of occurrence, the 5-year overall survival rate of patients with OSCC has not exceeded 55% over the previous decade, due to the local aggressiveness and high recurrence rate of the disease (2). Advanced OSCC remains refractory and results in mortality in >50% of cases (1).Complete locoregional control is crucial in the treatment of OSCC, as distant metastases are rarely identified at the initial presentation (3). Therefore, multimodal treatment has typically been implemented for advanced OSCC in order to control locoregional disease, generally consisting of radical surgery followed by radiotherapy (4). The issue with this combined therapeutic approach is the high recurrence rate at primary or regional sites within the first 2 years subsequent to treatment (5). As a result, 5-year survival rates have been low in patients treated with this therapy (5).Pre-operative chemoradiotherapy has become an established component of the clinical management of locoregionally advanced operable OSCC (6-10). Kirita et al has previously reported that pre-operative cisplatin (CDDP)-based intravenous chemotherapy and concurrent radiotherapy (total dose, ...

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“…However, postoperative dysfunction such as disturbances of speech, swallowing, mastication and esthetics can affect quality of life in advanced cases [2] , [8] . Studies employing adjuvant RT or chemoradiotherapy (CRT) after surgery outnumber studies of preoperative concepts, although preoperative therapy concepts have achieved good loco-regional control and a good survival rate as the standard approach in some institutions and have been rated positively in analytical reports [5] , [6] , [7] , [9] , [10] . Therefore, in recent decades, concurrent CRT for advanced oral SCC has been used to enable minimally invasive surgery or organ preservation [3] , [4] , [8] , [9] , [11] .…”

Section: Introductionmentioning

confidence: 99%

Role of 18F-fluorodeoxyglucose positron emission tomography/computed tomography in predicting pathological response to preoperative super-selective intra-arterial chemoradiotherapy for advanced squamous cell carcinoma of the mandible

Shibasaki

Iwai

Oguri

et al. 2018

Journal of Bone Oncology

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IntroductionAlthough chemoradiotherapy (CRT) for oral squamous cell carcinoma (SCC) has been shown to preserve organ function and improve cosmetic results, site-specific data, especially mandible, are limited. The aim of this study was to evaluate the predictability of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) on response to super-selective intra-arterial CRT for advanced SCC of the mandible.MethodsFifteen patients with advanced SCC of the mandible underwent super-selective intra-arterial CRT followed by radical resection. Maximum standardized uptake value (SUVmax) of the mandibular lesion was evaluated with FDG-PET/CT before and after CRT. The SUVmax before and after CRT was defined as pre-SUVmax and post-SUVmax, respectively. The difference between pre- and post-SUVmax was calculated as SUVmax reduction rate to evaluate treatment response of the mandibular lesion. Each SUVmax reduction rate and surgical specimen of the corresponding lesion was analyzed to evaluate an accuracy of the modality for predicting pathological response.ResultsThe median of pre-SUVmax was significantly lower than that of post-SUVmax (p = 0.001). Of the 15 patients, 6 had a pathological complete response (pCR) and 9 had a non-pCR. Neither pCR patients nor non-pCR patients showed significant difference of the median of SUVmax between pre- and post-CRT (pre-CRT p = 0.099 post-CRT p =0.074). The SUVmax reduction rate in patients with pCR was significantly higher than that with non-pCR (p = 0.002). Receiver operating characteristic analysis revealed that the optimal cut-off point of the reduction rate was 64.7%, with 83% sensitivity and 100% specificity.ConclusionsThese results concluded that SUVmax reduction rate can predict pathological complete response of preoperative super-selective intra-arterial CRT for advanced SCC of the mandible.

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Concurrent Chemoradiotherapy with Pirarubicin and 5-fluorouracil for Resectable Oral and Maxillary Carcinoma

Abstract: This concurrent chemoradiotherapy is very useful for oral and maxillary carcinoma as a preoperative modality with remarkably high response rate and acceptable adverse events.

Cited by 10 publications

References 12 publications

Preoperative concurrent chemotherapy with S-1 and radiotherapy for locally advanced squamous cell carcinoma of the oral cavity: Phase I trial

Preoperative concurrent chemotherapy with S-1 and radiotherapy for locally advanced squamous cell carcinoma of the oral cavity: Phase I trial

Clinicopathological evaluation of pre-operative chemoradiotherapy with S-1 as a treatment for locally advanced oral squamous cell carcinoma

Role of 18F-fluorodeoxyglucose positron emission tomography/computed tomography in predicting pathological response to preoperative super-selective intra-arterial chemoradiotherapy for advanced squamous cell carcinoma of the mandible

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