[Two cases of giant metastatic cervical lymphnode from oral cancer responding to concurrent chemoradiotherapy with...

We report two cases of giant metastatic cervical lymphnode from oral squamous cell carcinoma, successfully treated with concurrent chemoradiotherapy with S-1. Case 1 was a 80-year-old male who had an ipsilateral occult neck metastasis(52x46 mm mass)at level IV after surgery of the left tongue carcinoma(T2N0M0). Radiotherapy(2.0 Gy/day; 5 days/week)was given at a total dose of 66 Gy. Two courses of oral administration of S-1(61 mg/m2/day)for 2 weeks followed by 1-week rest period as one course was repeated with the concurrent radiotherapy. After the radiotherapy, the oral administration of S-1 alone was continued for 1 year under the same regimen. Case 2 was a 51-year-old male who had left tongue carcinoma(T4bN2cM0)with ipsilateral cervical lymphnode metastasis(88x44 mm mass). The same chemoradiotherapy(1.8 Gy/day; 5 days/week; a total dose of 63 Gy; S-1 53 mg/m2/day)was carried out as in case 1. These giant metastatic lymphnodes of case 1 and 2 disappeared by 3 and 6 months after radiotherapy, respectively, and achieved a complete response. This therapy may be effective not only for primary lesion of oral cancer, but also metastatic regional lymphnodes in some cases.