Rohde S, Kovács A F, Zanella F E, Berkefeld J, Turowski B
Institut für Neuroradiologie, Klinikum der Johann-Wolfgang-Goethe-Universität Frankfurt/Main.
Radiologe. 2005 Sep;45(9):843-50. doi: 10.1007/s00117-005-1245-7.
Modern treatment concepts for patients suffering from oral and oropharyngeal cancer include more and more adjuvant therapeutic options. Local chemotherapy offers the possibility to apply an extremely high drug concentration at the tumor site while minimizing possible side effects by systemic neutralization at the same time.
A total of 289 patients with histologically proven carcinoma of the oral cavity and the oropharynx underwent neoadjuvant intra-arterial chemotherapy with high-dosage cisplatin within a multimodal therapeutic setting. Concerning the TNM classification, more than 70% of the patients were classified as stages III and IV. The mean age at the time of intervention was 60 years, and 71% of the patients were male.
After the first cycle 19.3% of the patients presented with complete remission (grade I); 35.4% and 41.5% showed partial remissions (grade II) or stable disease (grade III), respectively. The mean observation time after treatment was 28 months (median: 24.2 months). Of the 137 patients who completed the full multimodal therapeutic scheme, 11% developed local recurrence, and 12.4% developed lymph node or distant metastasis. At the time of evaluation, 72.5% of these patients were still alive.
Intra-arterial chemotherapy is a safe and highly effective procedure that should be considered as an important option in multimodal therapeutic concepts for oral and oropharyngeal cancer.
口腔和口咽癌患者的现代治疗理念包含越来越多的辅助治疗选择。局部化疗能够在肿瘤部位应用极高的药物浓度，同时通过全身中和作用将可能的副作用降至最低。
共有289例经组织学证实的口腔和口咽癌患者在多模式治疗方案中接受了高剂量顺铂的新辅助动脉内化疗。在TNM分类方面，超过70%的患者被归类为III期和IV期。干预时的平均年龄为60岁，71%的患者为男性。
第一个周期后，19.3%的患者出现完全缓解（I级）；35.4%和41.5%的患者分别出现部分缓解（II级）或疾病稳定（III级）。治疗后的平均观察时间为28个月（中位数：24.2个月）。在完成完整多模式治疗方案的137例患者中，11%出现局部复发，12.4%出现淋巴结或远处转移。在评估时，这些患者中有72.5%仍然存活。
动脉内化疗是一种安全且高效的治疗方法，应被视为口腔和口咽癌多模式治疗理念中的重要选择。
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