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[口腔鳞状细胞癌中PEP-放化疗的可行性与根治性]

[Feasibility and radicality of PEP-chemoradiation therapy in oral squamous cell carcinoma].

作者信息

Hibi G, Okui K, Abe A, Murai T, Sugiura N, Yamauchi T, Mineno Y, Tsujikawa T, Oka T

机构信息

Dept. of Dent-Oral Surgery, Fujita-Gakuen Health University, School of Medicine.

出版信息

Gan To Kagaku Ryoho. 1990 Aug;17(8 Pt 2):1692-5.

PMID:1697157
Abstract

From 1981 to 1987, 26 patients with oral malignancies, previously untreated squamous cell carcinomas, were treated by chemoradiation therapy, which consisted of Linac irradiation (2 Gy/d) under continuous intraarterial administration of 1.6 mg/d peplomycin (PEP). Twenty of these 26 patients did not undergo resection of the primary sites during initial hospitalization. Radicality of the PEP chemoradiation therapy was assessed after a long-term follow-up. Patients of Stage I to IV numbered 4, 7, 1 and 8, respectively. Total dosage was 60 Gy of Linac irradiation under 80-110 mg infusion of PEP. Overall CR rate and actuarial 5-year-survival rate were 75% and 63%, respectively, while these rates were 92% and 83%, respectively, for the Stage I to III cases, but 50% and 29%, respectively, for the Stage IV patients. Actuarial 5-year-survival rate of the CR Stage I to III cases was 91%, significantly higher than that of Stage IV cases (66%). We conclude the following: (1) This treatment is not indicative for patients with only a limited evaluation of PR available in the early stage of the therapeutic course. (2) Limited or uncertain response might occur in Stage IV cases. (3) The prognosis for the great majority of Stage I to III patients, however, is excellent.

摘要

1981年至1987年,对26例口腔恶性肿瘤患者(均为未经治疗的鳞状细胞癌)采用放化疗,治疗方法为直线加速器照射(2Gy/天),同时持续动脉内给予培普利欧霉素(PEP)1.6mg/天。这26例患者中有20例在初次住院期间未进行原发部位切除。经过长期随访评估了PEP放化疗的根治性。Ⅰ至Ⅳ期患者分别为4例、7例、1例和8例。直线加速器照射总剂量为60Gy,PEP输注量为80 - 110mg。总体完全缓解(CR)率和5年精算生存率分别为75%和63%,而Ⅰ至Ⅲ期患者的这两个率分别为92%和83%,Ⅳ期患者则分别为50%和29%。Ⅰ至Ⅲ期CR患者的5年精算生存率为91%,显著高于Ⅳ期患者(66%)。我们得出以下结论:(1)对于在治疗过程早期仅可获得有限部分缓解(PR)评估的患者,这种治疗方法并不适用。(2)Ⅳ期患者可能出现有限或不确定的反应。(3)然而,绝大多数Ⅰ至Ⅲ期患者的预后良好。

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