Takemura Hideki, Kobayashi Sei, Katsuno Masahiro, Asano Rie, Morimoto Masato, Tachibana Shinya, Kubota Hayato, Iida Masaki, Kadokura Yoshiyuki, Sanbe Takeyuki
Dept. of Otolaryngology, Fujigaoka Hospital of Showa University.
Gan To Kagaku Ryoho. 2005 Dec;32(13):2065-9.
We have treated head and neck carcinoma by concurrent chemoradiotherapy combined with 5-fluorouracil (5-FU) and cisplatin (CDDP). However,this chemoradiotherapy could not show an enormous effect in the advanced carcinoma of Stage III and IV. Therefore,we changed the contents of the chemotherapy, i.e., we replaced 5-FU, one of the agents with time dependency, to continuous administration of TS-1 for 2 weeks,also replacing CDDP, one of the agents with dose dependency, to nedaplatin (CDGP) in order to reduce kidney dysfunction. In this concurrent chemoradiotherapy, oral TS-1 was continued for 2 weeks and CDGP was administered on the 4 th day from the start of TS-1. In addition, radiotherapy was performed concurrently. In this way,we performed a phase I clinical trial of concurrent chemoradiotherapy combining TS-1 and nedaplatin (CDGP). As for the incidence of adverse events,grade 3 mucositis due to radiation was observed in two patients. As a result of the phase I clinical trial,we decided the maximum-tolerated dose (MTD) of TS-1 to be 80 mg/m2 (maximum 120 mg/body) and 100 mg/m2 for CDGP, and then determined the recommended dose(RD) of TS-1 as 80 mg/m2 (maximum 120 mg/ body) TS-1 and of CDGP as 9 0 mg/m2 CDGP.
我们采用5-氟尿嘧啶(5-FU)和顺铂(CDDP)同步放化疗治疗头颈部癌。然而,这种放化疗对Ⅲ期和Ⅳ期晚期癌并未显示出显著效果。因此,我们改变了化疗方案,即把具有时间依赖性的药物之一5-FU换成持续服用2周的替吉奥(TS-1),同时把具有剂量依赖性的药物之一顺铂换成奈达铂(CDGP)以减少肾功能损害。在这种同步放化疗中,口服TS-1持续2周,CDGP在TS-1开始服用后的第4天给药。此外,同步进行放射治疗。通过这种方式,我们开展了替吉奥与奈达铂(CDGP)同步放化疗的Ⅰ期临床试验。关于不良事件的发生率,有两名患者出现了3级放射性黏膜炎。作为Ⅰ期临床试验的结果,我们确定替吉奥的最大耐受剂量(MTD)为80mg/m²(最大120mg/体),奈达铂为100mg/m²,然后确定替吉奥的推荐剂量(RD)为80mg/m²(最大120mg/体),奈达铂为90mg/m²。