Specenier Pol, Vermorken Jan B
Department of Medical Oncology, University Hospital Antwerp, Edegem, Belgium.
Curr Opin Oncol. 2007 May;19(3):195-201. doi: 10.1097/CCO.0b013e3280f00fe7.
This review presents new data on the role of taxanes and targeted therapies in the management of squamous cell carcinoma of the head and neck.
Taxane-containing triplets are clearly superior as an induction regimen in locally advanced squamous cell carcinoma of the head and neck when compared with cisplatin/5 fluorouracil which has been the standard for two decades. Preliminary data suggest that the addition of a taxane to cisplatin/5 fluorouracil as induction regimen followed by chemoradiation may be superior to chemoradiation alone. The addition of cetuximab to radiation prolongs locoregional control and survival without increasing mucositis. Areas of active investigation are the search for epidermal growth factor receptor mutations and the optimal way of integrating epidermal growth factor receptor-directed therapies into standard management. Meanwhile new targets are explored.
Taxane/cisplatin/5 fluorouracil induction chemotherapy is clearly superior to cisplatin/5 fluorouracil. Epidermal growth factor receptor directed therapies can safely be combined with radiation and the combination shows encouraging results.
本综述介绍了紫杉烷类药物和靶向治疗在头颈部鳞状细胞癌治疗中作用的新数据。
与已作为二十年标准治疗方案的顺铂/5-氟尿嘧啶相比，含紫杉烷类药物的三联疗法作为局部晚期头颈部鳞状细胞癌的诱导方案明显更具优势。初步数据表明，在顺铂/5-氟尿嘧啶诱导方案中加入紫杉烷类药物后再进行放化疗，可能优于单纯放化疗。在放疗中加入西妥昔单抗可延长局部区域控制时间和生存期，且不增加黏膜炎的发生率。正在积极研究的领域包括寻找表皮生长因子受体突变以及将表皮生长因子受体导向治疗纳入标准治疗的最佳方法。与此同时，也在探索新的靶点。
紫杉烷/顺铂/5-氟尿嘧啶诱导化疗明显优于顺铂/5-氟尿嘧啶。表皮生长因子受体导向治疗可安全地与放疗联合使用，且联合治疗显示出令人鼓舞的结果。
