Abstract
Combination therapy with S-1, superselective intra-arterial infusion of carboplatin (CBDCA), and radiation therapy has been used to treat patients with oral cancer in our department since 2005 for the purpose of improving treatment results and the possibility of minimally invasive surgery. In this study, the histopathologic responses, outcomes and toxicities of this regimen as a preoperative treatment were retrospectively examined.
Thirty-five patients were treated with the above-described regimen from 2005 to 2012. The subjects consisted of 25 patients (21 men and 4 women) who were treated with this combination therapy as preoperative treatment. The average age of the patients was 61.2 years. The primary cancer sites were the tongue (13 cases), lower gingiva (4 cases), upper gingiva (3 cases), buccal mucosa (4 cases), and the floor of the mouth (1 case). Eleven patients showed T2 disease, 9 showed T3 disease, and 5 showed T4 disease. Five patients exhibited advanced stage Ⅱ, 10 exhibited stage Ⅲ, and 10 exhibited stage Ⅳa.
The histological response according to the Oboshi–Shimosato classification was grade IIb or higher in 24 cases (96.0％). The 5-year overall survival rate was 82.1％ and the 5-year disease-specific survival rate was 92.0％. Adverse events more severe than grade 2 consisted of anemia in 2 cases, leukocytopenia in 3 cases, thrombocytopenia in 1 case, mucositis in 22 cases, and weight loss in 3 cases. The treatment protocol was completed as planned in all patients. Our results suggest that it may be possible to perform minimally invasive surgery in some cases. Further investigation is needed to control neck recurrence and distant metastasis.
