Complete response to abdominal bulky lymph node recurrence in an esophageal cancer patient treated with S-1 monotherapy: A case report.

Abstract

Esophageal cancer is a highly lethal malignancy of the upper gastrointestinal tract. The recurrence of the cancer indicates a poor prognosis, and even salvage therapy using multi-agent combination chemotherapy, which is considered more effective than single-agent chemotherapy, is not able to achieve a sufficient response. The present study reports the case of a 74-year-old male who presented to a local hospital with dysphagia in February 2006. Upon radiographic and pathological examination, the patient was diagnosed with squamous cell carcinoma of esophagus that was clinically staged as T3N1M1. The patient was referred to the University of Tokyo Hospital (Tokyo, Japan) for concurrent chemoradiotherapy using a radiation dose of 50.4 Gy in 28 fractions, and subsequently achieved a complete response (CR). At 8 years after the initial diagnosis and subsequent treatment, the patient presented with abdominal swollen lymph nodes that were 38 mm and 22 mm in diameter. Recurrent metastasis was diagnosed. A single-agent regimen was selected due to the patient's poor performance status. This consisted of 2 cycles of oral S-1 administration twice a day for 2 consecutive weeks, followed by 2 weeks of rest (80 mg/day for 14 days/cycle). A CR was achieved following the use of S-1 administration as salvage therapy. The patient exhibited no signs of recurrence subsequent to 9 months of follow-up. Overall, the present study reports that S-1 administration shows marked effectiveness in the treatment of huge recurrent lesions. S-1 is considered as a good treatment option in patients with poor a performance status who require salvage therapy.