Buffoli A, Morrica B, Frata P, La Face B
Istituto del Radio, Università, Brescia.
Radiol Med. 1992 May;83(5):636-40.
From January 1981 through December 1983, 49 untreated patients with locally advanced head and neck cancers were randomized in two groups to receive different radiochemotherapy regimens. Group A, including 29 cases, received 4 cycles of induction chemotherapy with Bleomycin, Methotrexate and Hydroxyurea before definitive external radiotherapy (60 Gy); group B, including 20 patients, received the same total dose of radiotherapy but the 4 cycles of chemotherapy, as described above, were administered between the 20- and the 40-Gy doses. Both groups were compared with a control group treated in the same period with radiotherapy (60 Gy) alone. The response to treatment was evaluated at the end of chemotherapy or radiotherapy alone and at the end of combined regimens. Long-term survival rates were analyzed for all groups relative to complete tumor response, disease-free interval and time to disease progression. In our experience the radio-chemotherapy combination, according to the described schedules, failed to improve both local control and overall survival; the comparison with the control group does not suggest that induction or intercalated chemotherapy can increase long-term survival even if initial complete and partial response rates are high.
从1981年1月至1983年12月，49例未经治疗的局部晚期头颈癌患者被随机分为两组，接受不同的放化疗方案。A组包括29例患者，在进行根治性外照射放疗（60 Gy）前接受4个周期的博来霉素、甲氨蝶呤和羟基脲诱导化疗；B组包括20例患者，接受相同总剂量的放疗，但上述4个周期的化疗在20 Gy至40 Gy剂量之间进行。两组均与同期仅接受放疗（60 Gy）的对照组进行比较。在单纯化疗或放疗结束时以及联合治疗方案结束时评估治疗反应。分析了所有组相对于肿瘤完全缓解、无病间期和疾病进展时间的长期生存率。根据我们的经验，按照所述方案进行的放化疗联合治疗未能改善局部控制率和总生存率；与对照组的比较并不表明诱导化疗或夹心化疗能提高长期生存率，即使初始完全缓解率和部分缓解率较高。
