Dobrowsky W, Dobrowsky E, Strassl H, Braun O, Gritzmann N, Scheiber V
Dept. of Radiotherapy and Radiobiology, University of Vienna, Austria.
Int J Radiat Oncol Biol Phys. 1991 Feb;20(2):239-42. doi: 10.1016/0360-3016(91)90097-n.
From May 1985 to June 1988, 70 evaluable patients with advanced squamous cell cancers of the oral cavity and the oropharynx were treated with preoperative combined radio-chemotherapy. Treatment consisted of 50 Gy/25 fractions/5 weeks, combined with concomitant administration of mitomycin C on day 1 (15 mg/m2, i.v. bolus) and 5-fluorouracil during the first 5 days of irradiation (750 mg/m2/24 hours, continuous infusion). Surgery was performed 3 to 5 weeks following irradiation. Treatment tolerance was good and local mucosal reaction was increased, but no major systemic side effects were recorded. At surgery, 3-5 weeks following irradiation, 48.6% of the operation specimens did not contain any histologically detectable residual tumor. Overall survival is 61%, being 69% in T2 and T3, while none of the patients with bone invasion has survived. Median survival is 28, 26, and 9 months in T2, T3 and T4 stages, respectively. Loco-regional relapses have been recorded in 33% of the patients, occurring in 27% of T2, 25% of T3, and 88% of T4 stages. Patients have been spared mutilating radical neck dissection because of combined presurgical treatment without impaired survival or loco-regional relapse rate.
1985年5月至1988年6月，70例可评估的口腔和口咽晚期鳞状细胞癌患者接受了术前放化疗联合治疗。治疗包括50 Gy分25次照射，共5周，同时在第1天静脉推注丝裂霉素C（15 mg/m²），并在照射的前5天持续输注5-氟尿嘧啶（750 mg/m²/24小时）。放疗后3至5周进行手术。治疗耐受性良好，局部黏膜反应有所增加，但未记录到严重的全身副作用。放疗后3至5周手术时，48.6%的手术标本中未发现任何组织学上可检测到的残留肿瘤。总生存率为61%，T2和T3期为69%，而有骨侵犯的患者无一存活。T2、T3和T4期的中位生存期分别为28个月、26个月和9个月。33%的患者出现局部区域复发，T2期为27%，T3期为25%，T4期为88%。由于术前联合治疗，患者避免了致残性的根治性颈部清扫术，且生存率和局部区域复发率未受影响。
