多西他赛、顺铂和5-氟尿嘧啶联合化疗（TPF）及局部晚期头颈部鳞状细胞癌（SCCHN）患者的放射治疗

[Combined chemotherapy with docetaxel, cisplatin and 5-fluorouracil (TPF), and radiotherapy in patients with locally advanced squamous cell carcinoma of the head and neck (SCCHN)].

作者信息

Katori Hideaki, Tsukuda Mamoru, Ishitoya Junichi, Mikami Yasukazu, Matsuda Hideki, Tanigaki Yuji, Horiuchi Chouichi, Ikeda Youichi, Kimura Machiko, Taguchi Takahide, Hirose Shouji, Yoshida Takashi, Takahashi Masahiro, Sakuma Yasunori, Yamamoto Kaoru, Sato Nao

机构信息

Department of Otolaryngology, Yokohama City University Medical Center, Yokohama.

出版信息

Nihon Jibiinkoka Gakkai Kaiho. 2005 Feb;108(2):157-63. doi: 10.3950/jibiinkoka.108.157.

DOI:10.3950/jibiinkoka.108.157

Abstract

We evaluated the recommend dose and efficacy of chemotherapy (CTx) and concurrent chemoradiotherapy (ConcCRTx) with docetaxel (DOC), cisplatin (CDDP) and 5-FU (TPF) in patients with locally advanced squamous cell carcinoma of the head and neck (SCCHN). Patients underwent 2 cycles of chemotherapy with TPF. In ConcCRTx, radiation was targeted to begin on Day 1. We compared the efficacy of ConcCRTx and induction chemotherapy followed by radiation (CTx followed by RTx) with TPF. In CTx followed by RTx, radiation was targeted to begin 21 days after the end of CTx. The recommend dose of CTx with TPF was DOC 60 (Day 1), CDDP 70 (Day 4) and 5 FU 750 (Day 1-5) mg/ m2/ day and overall response rate of CTx with TPF was 95%. The recommended dose of ConcCRTx was DOC 50 (Day 1), CDDP 60 (Day 4) and 5-FU 600 (Day 1-5) mg/ m2/ day. Overall response rate of ConcCRTx and CTx followed by RTx with TPF were both 100%, and CR rate of them were 87% and 84% (p > 0.05). One-year survival rate of them were 69% and 95% (p < 0.05). More patients had distant metastasis in CTx followed by RTx than in ConcCRTx. Toxicity, such as mucositis, leukocytopenia and neutropenia, was higher in ConcCRTx than in CTx followed by RTx.

摘要

我们评估了多西他赛（DOC）、顺铂（CDDP）和5-氟尿嘧啶（5-FU，TPF方案）用于局部晚期头颈部鳞状细胞癌（SCCHN）患者化疗（CTx）及同步放化疗（ConcCRTx）的推荐剂量和疗效。患者接受2个周期的TPF方案化疗。在同步放化疗组，放疗计划于第1天开始。我们比较了同步放化疗与诱导化疗后放疗（CTx后行RTx）采用TPF方案的疗效。在CTx后行RTx组，放疗计划于CTx结束后21天开始。TPF方案CTx的推荐剂量为：多西他赛60mg/m²（第1天）、顺铂70mg/m²（第4天）、5-氟尿嘧啶750mg/m²（第1 - 5天），TPF方案CTx的总体缓解率为95%。同步放化疗的推荐剂量为：多西他赛50mg/m²（第1天）、顺铂60mg/m²（第4天）、5-氟尿嘧啶600mg/m²（第1 - 5天）。同步放化疗组以及CTx后行RTx组采用TPF方案的总体缓解率均为100%，两组的完全缓解率分别为87%和84%（p>0.05）。两组的1年生存率分别为69%和95%（p<0.05）。CTx后行RTx组发生远处转移的患者多于同步放化疗组。同步放化疗组黏膜炎、白细胞减少和中性粒细胞减少等毒性反应高于CTx后行RTx组。