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[低剂量顺铂和5-氟尿嘧啶用于头颈癌患者]

[Low-dose CDDP and 5-FU for head and neck cancer patients].

作者信息

Fujii M, Kanke M, Tomita T

机构信息

Department of Otolaryngology, Keio University School of Medicine, Tokyo, Japan.

出版信息

Gan To Kagaku Ryoho. 1999 Oct;26(11):1542-7.

Abstract

Combination chemotherapy with CDDP and 5-FU is one of the most effective regimens for head and neck cancer. Recent studies have focused on biochemical modulation in the combination of CDDP and 5-FU. We studied the difference in effectiveness and adverse effects between two CDDP administration schedules for CDDP-5-FU combination chemotherapy. For regimen A, CDDP was administered on 5 consecutive days from day 1 to day 5, with a daily dose of 16 mg/m2. For regimen B, CDDP was administered at 80 mg/m2 on day 1. 5-FU was administered at 600 mg/m2/day in a continuous drip infusion for 120 hours from day 1 to day 5 for regimens A and B. Twenty-seven patients with head and neck squamous cell carcinoma were included in this study, and received either regimen A or B. Thirteen patients were given regimen A and 14 regimen B. With regimen A, 3 patients showed CR and the response rate was 76.9%. With regimen B, 3 patients showed CR and the response rate was 64.3%. The rates of efficacy were not different between regimen A and B. In contrast, a difference was seen with organ toxicity. Regimen B was more toxic for renal function than regimen A, while regimen A showed greater toxicity to bone marrow function. Acute nausea and vomiting were observed more frequently with regimen B. The difference in organs and symptoms of adverse effects, according to the schedule of CDDP administration would seem to be important in the treatment of head and neck cancer patients. The schedule of CDDP administration should be adjusted depending on the renal and bone marrow functions of the patients. Because multiple infusion of CDDP proved to be efficacious, low-dose CDDP and 5-FU will have a role for patients with head and neck squamous cell carcinoma. We also introduce other reports on the efficacy of low-dose CDDP and 5-FU.

摘要

顺铂(CDDP)与5-氟尿嘧啶(5-FU)联合化疗是头颈癌最有效的治疗方案之一。近期研究聚焦于CDDP与5-FU联合化疗中的生化调节。我们研究了CDDP-5-FU联合化疗中两种CDDP给药方案在疗效和不良反应方面的差异。方案A中,从第1天至第5天连续5天给予CDDP,每日剂量为16mg/m²。方案B中,在第1天给予CDDP 80mg/m²。对于方案A和方案B,5-FU均在第1天至第5天以600mg/m²/天的剂量持续静脉滴注120小时。本研究纳入了27例头颈鳞状细胞癌患者,分别接受方案A或方案B治疗。13例患者接受方案A,14例接受方案B。方案A组有3例患者达到完全缓解(CR),缓解率为76.9%。方案B组有3例患者达到CR,缓解率为64.3%。方案A和方案B的疗效率无差异。相比之下,在器官毒性方面存在差异。方案B对肾功能的毒性大于方案A,而方案A对骨髓功能的毒性更大。方案B中急性恶心和呕吐的发生率更高。根据CDDP给药方案,不良反应的器官和症状差异对头颈癌患者的治疗似乎很重要。应根据患者的肾功能和骨髓功能调整CDDP给药方案。由于多次输注CDDP已证明有效,低剂量CDDP和5-FU对头颈鳞状细胞癌患者将有一定作用。我们还介绍了其他关于低剂量CDDP和5-FU疗效的报道。

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