Two elderly patients with advanced maxillary gingival carcinoma with complete response to concurrent radiotherapy and S-1 chemotherapy

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The use of the novel oral fluoropyrimidine anticancer drug S-1 as a single agent or in combined chemotherapy has been reported to be useful for the treatment of advanced oral cancer. We report two elderly patients with advanced oral cancer who achieved complete response (CR) after concurrent radiotherapy and S-1 chemotherapy. Patient 1 was an 81-year-old woman who had a 50. mm × 40. mm tumor erosion in the right upper gingival region. At 2.5 years after the end of concurrent radiotherapy and S-1 chemotherapy, tumor relapse was observed, although CR continued temporarily. The patient died 3 years after the end of concurrent radiotherapy and S-1 chemotherapy due to tumor relapse and high blood pressure resulting in deterioration of patient condition. Patient 2 was an 89-year-old woman who had a 40. mm × 30. mm tumor ulcer in the right gingiva. Neither relapse nor metastasis was seen, and patient condition remained good for the 3 years after concurrent radiotherapy and S-1 chemotherapy. In both patients, MRI showed that the tumor had deeply invaded the palatal bone, almost reaching the nasal cavity, with metastasis to the right upper superior internal jugular nodes. In both patients, biopsy showed a well-differentiated squamous cell carcinoma. Concurrent radiotherapy and S-1 chemotherapy induced CR without severe adverse effects. © 2010 Asian Association of Oral and Maxillofacial Surgeons.