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顺铂化疗对头颈部癌的临床疗效及毒性——东海地区多机构联合研究

[Clinical effects and toxicity of chemotherapy with cisplatin for head and neck cancer--the multi-institutional joint research in Tokai district].

作者信息

Tohnai I, Kawabe Y, Nakashima T, Yamagiwa M, Suzuki T, Mizuno A, Mineda H

机构信息

Department of Oral Surgery, Nagoya University School of Medicine.

出版信息

Nihon Gan Chiryo Gakkai Shi. 1990 Oct 20;25(10):2567-78.

PMID:1702133
Abstract

We investigated the clinical effects and toxicity of chemotherapy with Cisplatin (CDDP) for head and neck cancer as the third joint research project of the Tokai Meeting for Head and Neck Tumors. The cases were examined at the cooperating institutions from September 1986 to March 1988. The subjects were 93 cases consisting of 66 patients (intravenous infusion: 47 cases; intraarterial infusion: 19 cases) of PP therapy (CDDP + PEP), 16 cases of PF therapy (CDDP + 5-FU) and 11 cases of PPV therapy (CDDP + PEP + VCR). The regimens of PP therapy were: CDDP 50-100 mg/body x 1 day, PEP 5 mg/body x 5 days (i.v.), and CDDP 10-20 mg/body x 5 days, PEP 5-10 mg/body x 5 days (i.a.). In the regimen of PF therapy, CDDP 80-100 mg/body x 1 day and 5-FU 750-1,000 mg/body x 5 days were administered. In the regimen of PPV therapy, CDDP 80-100 mg/body x 1 day, PEP 5 mg/body x 5 days and VCR 1 mg/body x 1 day were administered. As a rule, two courses of each of the regimens were performed. The total dose of CDDP in intraarterial infusion of PP therapy was significantly less than in intravenous infusion. The major results were as follows: 1) Total response rate was 57.0% on the average, and this was not significantly different among the regimens. 2) The response rate of intraarterial infusion of PP therapy was as high as that for intravenous infusion in spite of the lower CDDP dose. 3) The response rate of oral cavity was significantly higher than that of nasal cavity and paranasal sinuses. 4) In the squamous cell carcinoma, the response rate of the well differentiated type was significantly higher than that of the poorly differentiated type. 5) The leukocyte counts significantly decreased with the intravenous infusion of PP therapy, PF therapy and PPV therapy. 6) The platelet counts significantly decreased with PPV therapy. 7) There were no significant changes with time with Ccr and PaO2 of PP therapy. 8) The frequency of toxicities such as nausea and vomiting was high in the intravenous infusion of PP therapy, PF therapy and PPV therapy. However, the frequency of toxicity was low in the intraarterial infusion of PP therapy.

摘要

作为东海头颈肿瘤会议的第三个联合研究项目,我们调查了顺铂(CDDP)化疗对头颈癌的临床疗效和毒性。1986年9月至1988年3月,在合作机构对病例进行了检查。研究对象为93例,其中PP方案(CDDP + PEP)66例(静脉输注:47例;动脉内输注:19例),PF方案(CDDP + 5-FU)16例,PPV方案(CDDP + PEP + VCR)11例。PP方案为:CDDP 50 - 100mg/体×1天,PEP 5mg/体×5天(静脉注射),以及CDDP 10 - 20mg/体×5天,PEP 5 - 10mg/体×5天(动脉内注射)。PF方案中,给予CDDP 80 - 100mg/体×1天和5-FU 750 - 1000mg/体×5天。PPV方案中,给予CDDP 80 - 100mg/体×1天,PEP 5mg/体×5天和VCR 1mg/体×1天。通常,每个方案进行两个疗程。PP方案动脉内输注时CDDP的总剂量明显低于静脉输注。主要结果如下:1)平均总缓解率为57.0%,各方案之间无显著差异。2)尽管PP方案动脉内输注的CDDP剂量较低,但其缓解率与静脉输注一样高。3)口腔的缓解率明显高于鼻腔和鼻窦。4)在鳞状细胞癌中,高分化型的缓解率明显高于低分化型。5)PP方案静脉输注、PF方案和PPV方案时白细胞计数明显下降。6)PPV方案时血小板计数明显下降。7)PP方案的肌酐清除率(Ccr)和动脉血氧分压(PaO2)随时间无显著变化。8)PP方案静脉输注、PF方案和PPV方案时恶心、呕吐等毒性反应的发生率较高。然而,PP方案动脉内输注时毒性反应的发生率较低。

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