Bertino Giulia, Occhini Antonio, Falco Carlo Emilio, Porta Camillo, Corbella Franco, Colombo Sara, Balcet Vittoria, Morbini Patrizia, Zappoli Federico, Azzaretti Andrea, Rodolico Giuseppe, Tinelli Carmine, Benazzo Marco
Department of Otolaryngology Head Neck Surgery, University of Pavia, IRCCS Policlinico S, Matteo Foundation, P.le Golgi 2, 27100 Pavia, Italy.
BMC Cancer. 2009 Sep 4;9:313. doi: 10.1186/1471-2407-9-313.
The aim of the present study was to evaluate the survival, efficacy and safety of a modified RADPLAT-like protocol using carboplatin instead of cisplatin.
Fifty-six patients with primary head and neck squamous cell carcinoma received 4 cycles of intra-arterial carboplatin (350 mg/m2 per cycle every 2 weeks), with concurrent three-dimensional conformal radiation therapy.
Two major and 4 minor complications were observed. Forty-five of the 56 patients (80%) completed the protocol, while 11 (20%) patients had to discontinue the intra-arterial infusions due to the occurrence of severe haematological toxicity, but were able to complete radiotherapy. Forty-four (98%) of the 45 patients who completed the protocol and 10 (91%) of the 11 who did not, were free of disease at the end of the treatment, for a comprehensive 96% of CR overall. After a median 23.55 months (range: 2 to 58 months) of follow-up, 40 patients (71%) are alive and disease-free, 1 (2%) is alive but affected by disease and 15 (27%) have died of the disease or other causes.
Intra-arterial carboplatin administration with concurrent three-dimensional conformal radiation therapy seems to be a promising alternative to RADPLAT in the treatment of advanced head and neck tumours. Haematological and non-haematological toxicities are virtually similar, but carboplatin has the advantage in that it is not nephrotoxic and can be used at very high doses without any significant increase in the extent of side effects.
本研究的目的是评估使用卡铂替代顺铂的改良类RADPLAT方案的生存率、疗效和安全性。
56例原发性头颈部鳞状细胞癌患者接受4个周期的动脉内卡铂治疗（每2周350mg/m²/周期），同时进行三维适形放疗。
观察到2例主要并发症和4例次要并发症。56例患者中有45例（80%）完成了方案，而11例（20%）患者因发生严重血液学毒性不得不停止动脉内输注，但能够完成放疗。完成方案的45例患者中有44例（98%），未完成方案的11例患者中有10例（91%）在治疗结束时无疾病，总体完全缓解率为96%。中位随访23.55个月（范围：2至58个月）后，40例患者（71%）存活且无疾病，1例（2%）存活但患有疾病，15例（27%）死于该疾病或其他原因。
动脉内给予卡铂并同时进行三维适形放疗似乎是治疗晚期头颈部肿瘤的一种有前景的替代RADPLAT方案。血液学和非血液学毒性基本相似，但卡铂的优势在于它没有肾毒性，可以高剂量使用而不会显著增加副作用的程度。
