Strojan Primoz, Soba Erika, Budihna Marjan, Auersperg Marija
Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia.
J Surg Oncol. 2005 Dec 15;92(4):278-83. doi: 10.1002/jso.20422.
To explore whether the combined radiochemotherapy with Vinblastine, Methotrexate, and Bleomycin could be an effective alternative treatment to surgery in verrucous carcinoma (VC) of the head and neck.
Combined radiochemotherapy was used in 12 patients with previously untreated VC. They were irradiated to equivalent tumor dose of 44-70 Gy (median, 56 Gy) and had > or = 2 courses of concomitant chemotherapy. Chemotherapy regimen consisted of prolonged intravenous infusions of Vinblastine 2 mg (day 1); Methotrexate 50 mg (day 2); Bleomycin 15 mg (days 2 and 3), and repetition at 2-3 week intervals.
Eleven of 12 patients were cured of VC, and one died of purulent meningitis associated with intracranial extension of VC from the oral cavity. Of 11 patients cured of VC, eight had advanced tumors. The median follow-up of cured patients was 3.6 years (range, 1.4-13.6 years). All the patients developed mucositis of grade > or = 3, whereas no serious late side-effects were recorded.
Combined radiochemotherapy with Vinblastine, Methotrexate, and Bleomycine is highly effective in the treatment of VC of the head and neck. It could be successfully used in the patients with inoperable VC or as an alternative to surgery.
探讨长春碱、甲氨蝶呤和博来霉素联合放化疗能否作为头颈部疣状癌（VC）手术治疗的有效替代方案。
12例初治的VC患者接受联合放化疗。给予肿瘤等效剂量44 - 70 Gy（中位剂量56 Gy）的放疗，并进行≥2个疗程的同步化疗。化疗方案包括长春碱2 mg静脉滴注（第1天）；甲氨蝶呤50 mg（第2天）；博来霉素15 mg（第2天和第3天），每2 - 3周重复一次。
12例患者中11例VC治愈，1例死于与口腔VC颅内扩展相关的化脓性脑膜炎。在11例治愈的患者中，8例为晚期肿瘤。治愈患者的中位随访时间为3.6年（范围1.4 - 13.6年）。所有患者均出现≥3级黏膜炎，但未记录到严重的晚期副作用。
长春碱、甲氨蝶呤和博来霉素联合放化疗对头颈部VC治疗效果显著。可成功用于无法手术的VC患者或作为手术替代方案。
