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Clinical Oral Investigations
Published in: Clinical Oral Investigations 6/2019

01-06-2019 | Original Article

Outcomes after up-front surgery and metronomic neoadjuvant chemotherapy with S-1 or UFT for early tongue squamous cell carcinoma

Authors: Shinichiro Kina, Toshiyuki Nakasone, Takao Kinjo, Fumikazu Nimura, Nao Sunagawa, Akira Arasaki

Published in: Clinical Oral Investigations | Issue 6/2019

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Abstract

Background

Our aim was to investigate the disease-free survival in patients with tongue squamous cell carcinoma receiving metronomic neoadjuvant chemotherapy with 5-fluorouracil prodrugs (UFT or S-1) plus bleomycin compared with those who had up-front surgery retrospectively.

Methods

In this retrospective study, 108 patients with stages I to II tongue squamous cell carcinoma who had undergone surgery were divided into the “surgery group” or “neoadjuvant chemotherapy group.”

Results

A total of 41 patients received up-front surgery; 67 received metronomic neoadjuvant chemotherapy with UFT plus bleomycin (39) or S-1 plus bleomycin (28). The rate of disease-free survival was the primary outcome measure. Neoadjuvant 5-fluorouracil prodrugs did not correlate higher with improved disease-free survival than up-front surgery (72 and 54%, respectively; hazard ratio for recurrence or death, 0.54; 95% confidence interval [CI], 0.28 to 1.03; P = 0.06). Patients who received S-1 were more likely than those who received UFT to have pathological complete response (46% vs. 15%; P = 0.007). Neoadjuvant S-1 significantly improved disease-free survival as compared with up-front surgery (79% vs. 54%; hazard ratio, 0.41; 95% CI, 0.15 to 0.98; P = 0.04). However, neoadjuvant UFT did not improve disease-free survival as compared with up-front surgery (67% vs. 54%, respectively; hazard ratio, 0.66; 95% CI, 0.31 to 1.33; P = 0.24).

Conclusions

Neoadjuvant S-1 chemotherapy, as compared with up-front surgery, significantly improved disease-free survival among patients with tongue squamous cell carcinoma.

Clinical relevance

A choice of drugs before neoadjuvant metronomic chemotherapy is needed.
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Metadata
Title
Outcomes after up-front surgery and metronomic neoadjuvant chemotherapy with S-1 or UFT for early tongue squamous cell carcinoma
Authors
Shinichiro Kina
Toshiyuki Nakasone
Takao Kinjo
Fumikazu Nimura
Nao Sunagawa
Akira Arasaki
Publication date
01-06-2019
Publisher
Springer Berlin Heidelberg
Published in
Clinical Oral Investigations / Issue 6/2019
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI
https://doi.org/10.1007/s00784-018-2689-2

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