Bernier Jacques
Service de radio-oncologie, Clinique de Genolier, 1272 Genolier, Suisse.
Bull Cancer. 2007 Sep;94(9):823-7.
Following the release, in 2004, of the results from 2 multicentric, phase III studies, the adjuvant treatment of locally advanced head-and-neck cancers nowadays belongs to Level I of Evidence-Based Medicine, with the advent of concomitant, high-dose chemoradiation. The concurrent delivery of radiotherapy (60 to 66 Gy using a conventional fractionation) and high-dose, bolus cisplatin (100 mg/m2, days 1, 22 and 43) is considered, in post-operative setting, as the standard approach in patients with locally advanced disease. Future adjuvant treatments should anchor to the development of high-precision irradiation techniques, as well as concomitant delivery of radiotherapy with more efficacious cytotoxic drugs and/or targeted therapies.
2004年两项多中心III期研究结果发布后，随着同步大剂量放化疗的出现，局部晚期头颈癌的辅助治疗如今属于循证医学I级。在术后情况下，同步给予放疗（采用常规分割方式，剂量为60至66 Gy）和大剂量推注顺铂（100 mg/m²，第1、22和43天）被认为是局部晚期疾病患者的标准治疗方法。未来的辅助治疗应基于高精度放疗技术的发展，以及放疗与更有效的细胞毒性药物和/或靶向治疗的同步应用。
