Safety and efficacy of S-1 chemotherapy in recurrent and metastatic nasopharyngeal carcinoma patients after failure of platinum-based chemotherapy: multi-institutional retrospective analysis

Abstract

Pei-Jian Peng,1,* Hua Cheng,2,* Xue-Qing Ou,3 Lin-Juan Zeng,1 Xuan Wu,4 Yu-Meng Liu,5 Zhong Lin,1 Yan-Na Tang,1 Si-Yang Wang,3 Hong-Yu Zhang,1 Zhi-Bin Chen3 1Department of Medical Oncology, 2Department of Surgical Oncology, 3Department of Radiation Oncology, The Fifth Affiliated Hospital of Sun-Yat-Sen University, Zhu Hai, Guangdong Province, People's Republic of China; 4Department of Medical Oncology, Cancer Center, Sun-Yat-Sen University, Guangzhou, People's Republic of China; 5Department of Oncology, the People's Hospital of Zhongshan City, Zhongshan, Guangdong Province, People's Republic of China *These authors contributed equally to this work Purpose: This retrospective study evaluates the efficacy and safety of S-1 chemotherapy for recurrent and metastatic nasopharyngeal carcinoma patients after failure of platinum-based chemotherapy. Patients and methods: Thirty-nine patients with recurrent and metastatic nasopharyngeal carcinoma who failed previous platinum-based chemotherapy received oral S-1 chemotherapy (twice daily from day 1 to 14) every 3 weeks. The dose of S-1 was determined according to the body surface area (BSA): 40 mg twice a day for BSA <1.25 m2; 50 mg twice a day for 1.25 m2 ≤BSA<1.5 m2; and 60 mg twice a day for BSA ≥1.5 m2. Results: Treatment was well tolerated. Most adverse events were mild. Grade 3 hematological toxicity occurred in 7.7%. There was one complete response (2.6%) and 12 partial responses (30.7%), giving an overall response rate of 33.3% (95% CI [confidence interval], 21.7–50.8). Median time-to-progression was 5.6 months, and median survival was 13.9 months. One- and 2-year survival rates were 60% and 26%, respectively. Conclusion: S-1 monotherapy is considered a safe and effective treatment option for recurrent and metastatic nasopharyngeal carcinoma patients after failure of platinum-based chemotherapy. Keywords: S-1, nasopharyngeal carcinoma, chemotherapy, platinum