Andreadis C, Vahtsevanos K, Sidiras T, Thomaidis I, Antoniadis K, Mouratidou D
3rd Department of Clinical Oncology, Theagenion Cancer Hospital, 2, Alex Simeonidis Str, Thessaloniki 54007, Greece.
Oral Oncol. 2003 Jun;39(4):380-5. doi: 10.1016/s1368-8375(02)00141-0.
The benefit of the effect of chemotherapy in patients with advanced head and neck squamous cell tumors have been demonstrated by recent meta-analyses of randomized studies. However, the role of chemotherapy-especially in advanced oral cancer-is not fully clear, because of the very small amount of phase II literature available. From January 1994 to December 2000, a total of 44 pts aged 33-75 years (mean age 60 years) with advanced and histologically proved squamous cell carcinoma's of the oral cavity received at least one chemotherapy course. Seven patients had stage III and 37 stage IV disease. The chemotherapy was the initial therapy in a group of 21 patients. In a second group of 23 patients the chemotherapy was delivered after relapse of their disease. The pre-chemotherapy treatment of the second group was radiotherapy in 11, surgery in 4, combination of radiotherapy and surgery in 8 patients. The chemotherapy regimen consisted of cisplatin 100 mg/m(2) in 3-h infusion, day 1 and 5-FU 1000 mg/m(2) in 24-h infusion, days 1-5. Treatment was repeated every 21 days. A total of 154 treatment courses (3.5 per patient, ranged 1-10) were administered. Myelotoxicity, nausea and vomiting were the major treatment complications. The overall response rate to the induction chemotherapy was 52.3%, with 19% complete (CR), and 33.3% partial response's (PR) and to the chemotherapy for recurrent/metastatic disease 30.4% with 8.7% CR, and 21.7% PR. No difference was found in the median survival of the two subgroups (12 months). The median survival of the responders was 15 months (95% CI 11.3-18.7 months), and of the non-responders 9 months (95% CI 5.6-12.4 months) (P = 0.0067). Chemotherapy with cisplatin and 5-FU combination is effective in pts with advanced squamous cell oral cancer and appears to improve the survival of patients who have a good response.
近期对随机研究的荟萃分析已证实化疗对晚期头颈部鳞状细胞肿瘤患者的疗效。然而，由于可用的II期文献数量极少，化疗的作用，尤其是在晚期口腔癌中的作用尚不完全清楚。1994年1月至2000年12月，共有44例年龄在33 - 75岁（平均年龄60岁）、经组织学证实为晚期口腔鳞状细胞癌的患者接受了至少一个疗程的化疗。7例患者为III期，37例为IV期。化疗是21例患者的初始治疗。在另一组23例患者中，化疗在疾病复发后进行。第二组患者化疗前的治疗，11例为放疗，4例为手术，8例为放疗与手术联合。化疗方案为第1天和顺铂100 mg/m²静脉滴注3小时，第1 - 5天5 - 氟尿嘧啶1000 mg/m²持续静脉滴注24小时。每21天重复治疗。共进行了154个疗程的治疗（每位患者3.5个疗程，范围为1 - 10个疗程）。骨髓毒性、恶心和呕吐是主要的治疗并发症。诱导化疗的总缓解率为52.3%，其中完全缓解（CR）为19%，部分缓解（PR）为33.3%；复发性/转移性疾病化疗的总缓解率为30.4%，其中CR为8.7%，PR为21.7%。两个亚组的中位生存期无差异（12个月）。缓解者的中位生存期为15个月（95%可信区间11.3 - 18.7个月），未缓解者为9个月（95%可信区间5.6 - 12.4个月）（P = 0.0067）。顺铂和5 - 氟尿嘧啶联合化疗对晚期口腔鳞状细胞癌患者有效，似乎能提高反应良好患者的生存率。
