Fuwa Nobukazu
Department of Radiation Oncology, Aichi Cancer Center Hospital.
Nihon Igaku Hoshasen Gakkai Zasshi. 2002 Feb;62(2):65-72.
Radiation therapy was the conventional treatment for locally advanced, nonresectable head and neck cancer. However, therapeutic results were poor with this treatment modality, and chemoradiotherapy has been used in an effort to improve therapeutic results. Improved local-regional control and disease-free or overall survival have been shown in several randomized trials using a concurrent or alternative approach. Induction chemotherapy (neoadjuvant chemotherapy), however, has not been shown to improve local-regional control or survival. Induction chemotherapy followed by definitive radiotherapy may be useful in the selection of patients who are likely to benefit from non-surgical organ preservation treatment schemes. Further clinical trials are needed to clarify the most suitable combination of chemotherapy and radiation. Intraarterial chemotherapy combined with radiation therapy for head and neck cancer has been attempted for many years. However, the indications, clinical significance, and selection of suitable anti-cancer drugs remain unclarified. The modern superselective intraarterial approach should be re-evaluated. Many head and neck cancers have been found to overexpress the receptor to epidermal growth factor (EGFR). Antibodies such as IMC-C225 that specifically target EGF receptors with radiotherapy and/or chemotherapy may prove to be valuable contributors to the treatment of advanced head and neck cancer.
放射治疗是局部晚期、不可切除的头颈癌的传统治疗方法。然而，这种治疗方式的治疗效果不佳，因此已采用放化疗来提高治疗效果。在几项采用同步或交替方法的随机试验中，已显示局部区域控制以及无病生存期或总生存期有所改善。然而，诱导化疗（新辅助化疗）尚未显示能改善局部区域控制或生存期。诱导化疗后进行根治性放疗可能有助于选择可能从非手术器官保留治疗方案中获益的患者。需要进一步的临床试验来明确化疗和放疗的最合适组合。动脉内化疗联合放疗治疗头颈癌已尝试多年。然而，其适应证、临床意义以及合适抗癌药物的选择仍不明确。现代超选择性动脉内方法应重新评估。已发现许多头颈癌过度表达表皮生长因子（EGFR）受体。像IMC-C225这样特异性靶向EGFR受体并联合放疗和/或化疗的抗体可能被证明是晚期头颈癌治疗的重要贡献者。
