Fountzilas G, Daniilidis J, Sridhar K S, Kalogera-Fountzila A, Zaramboukas T, Sombolos K, Destouni-Salem E, Vritsios A, Tourkantonis A
First Department of Internal Medicine, AHEPA University Hospital, Thessaloniki, Greece.
Cancer. 1990 Oct 1;66(7):1453-60. doi: 10.1002/1097-0142(19901001)66:7<1453::aid-cncr2820660703>3.0.co;2-x.
Sixty-six patients with locally advanced (Stages III and IV) carcinoma of the head and neck were treated with three cycles of induction chemotherapy, consisting of cisplatin, fluorouracil (FU) infusion, bleomycin, mitomycin, and hydroxyurea, followed by radiotherapy and/or surgery. There were 48 men and 18 women with a median age of 55 years (range, 18 to 75 years) and Karnofsky performance status of 80 (range, 40 to 90). Primary site was nasopharynx (28 patients), followed by larynx (12) and others (26). Forty-one (62%) patients were presented with Stage IV disease. The response rate to induction chemotherapy was 27% complete response, 50% partial response, 20% stable disease, and 3% progressive disease. There was no significant difference in response rate between patients with cancer of nasopharynx or other sites (P greater than 0.1). Survival was 61% at 24 months. Patients with cancer of nasopharynx had a better survival than those with other primaries (P = 0.033). Toxicities from chemotherapy included alopecia (73%), nausea/vomiting (66%), leukopenia (54%), stomatitis (36%), anemia (32%), thrombocytopenia (16%), and diarrhea (9%). Grade IV toxicity was not observed. Induction chemotherapy with this new regimen resulted in a high response rate but may not be superior to cisplatin and FU alone. It can be safely combined with radiotherapy as a potentially curative therapy in squamous cell carcinoma of the head and neck. Chemotherapy followed by radiation therapy may yield survival similar to radical surgery in laryngeal and other head and neck cancers.
66例局部晚期（Ⅲ期和Ⅳ期）头颈部癌患者接受了三个周期的诱导化疗，化疗方案包括顺铂、氟尿嘧啶（FU）静脉滴注、博来霉素、丝裂霉素和羟基脲，随后进行放疗和/或手术。其中男性48例，女性18例，中位年龄55岁（范围18至75岁），卡氏评分80分（范围40至90分）。原发部位为鼻咽（28例患者），其次是喉（12例）和其他部位（26例）。41例（62%）患者为Ⅳ期疾病。诱导化疗的缓解率为完全缓解27%、部分缓解50%、病情稳定20%、病情进展3%。鼻咽癌患者与其他部位癌患者的缓解率无显著差异（P大于0.1）。24个月生存率为61%。鼻咽癌患者的生存率高于其他原发部位癌患者（P = 0.033）。化疗的毒性反应包括脱发（73%）、恶心/呕吐（66%）、白细胞减少（54%）、口腔炎（36%）、贫血（32%）、血小板减少（16%）和腹泻（9%）。未观察到Ⅳ级毒性反应。这种新方案的诱导化疗缓解率高，但可能并不优于单纯顺铂和FU。它可安全地与放疗联合，作为头颈部鳞状细胞癌的一种潜在治愈性疗法。化疗后放疗在喉癌和其他头颈部癌中的生存率可能与根治性手术相似。
