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电穿孔联合博来霉素瘤内治疗在晚期头颈部鳞状细胞癌管理中的作用

The role of intratumour therapy with electroporation and bleomycin in the management of advanced squamous cell carcinoma of the head and neck.

作者信息

Bloom D C, Goldfarb P M

机构信息

Department of Otolaryngology--Head and Neck Surgery, Naval Medical Center Portsmouth, 620 John Paul Jones Circle, Portsmouth, VA 23708, USA.

出版信息

Eur J Surg Oncol. 2005 Nov;31(9):1029-35. doi: 10.1016/j.ejso.2005.04.007. Epub 2005 Sep 8.

Abstract

OBJECTIVES

To determine the safety and efficacy of electroporation with bleomycin in patients with advanced squamous cell carcinoma of the head and neck.

METHODS

Two open-label, multicenter, single-arm Phase II studies of intratumour electroporation therapy. Sixty-two patients with 86 squamous cell carcinoma tumours of the head and neck were enrolled. Twenty-five patients were treated with bleomycin alone. Fifty-four patients (17 initially treated with bleomycin alone) were treated with electroporation and bleomycin therapy. Local tumour response was measured.

RESULTS

In the bleomycin alone group, one tumour showed a partial response and 36 tumours showed no response to treatment. In the bleomycin with electroporation groups, 17 tumours showed complete response, 22 tumours showed partial response and 30 failed to achieve more than a 50% reduction in tumour size (no response). Bleomycin with electroporation had a significantly (p<0.001) greater number of patients showing a partial or complete response to the therapy when compared to bleomycin alone. Thirteen adverse events were reported which included five episodes of local bleeding, six local infections, one local tongue swelling and one cardiac arrhythmia.

CONCLUSIONS

Fifty-seven percent of squamous cell carcinomas of the head and neck demonstrated a partial or complete response to intratumour electroporation with bleomycin suggesting that further work investigating its use as a treatment for local control of these lesions should be pursued.

摘要

目的

确定博来霉素电穿孔治疗晚期头颈部鳞状细胞癌患者的安全性和有效性。

方法

两项开放标签、多中心、单臂II期肿瘤内电穿孔治疗研究。招募了62例患有86个头颈部鳞状细胞癌肿瘤的患者。25例患者仅接受博来霉素治疗。54例患者(17例最初仅接受博来霉素治疗)接受了电穿孔和博来霉素治疗。测量局部肿瘤反应。

结果

在仅使用博来霉素的组中,1个肿瘤显示部分缓解,36个肿瘤对治疗无反应。在博来霉素联合电穿孔组中,17个肿瘤显示完全缓解,22个肿瘤显示部分缓解,30个肿瘤未能使肿瘤大小缩小超过50%(无反应)。与单独使用博来霉素相比,博来霉素联合电穿孔治疗后显示部分或完全缓解的患者数量显著更多(p<0.001)。报告了13例不良事件,包括5次局部出血、6次局部感染、1次局部舌肿胀和1次心律失常。

结论

57%的头颈部鳞状细胞癌对博来霉素肿瘤内电穿孔显示部分或完全缓解,这表明应进一步开展研究,探讨其作为这些病变局部控制治疗方法的应用。

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