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舌根部局部晚期鳞状细胞癌的放化疗。

Chemoradiotherapy for locoregionally advanced squamous cell carcinoma of the base of tongue.

机构信息

Department of Radiation and Cellular Oncology, University of Chicago, Chicago, IL, USA.

出版信息

Head Neck. 2010 Nov;32(11):1519-27. doi: 10.1002/hed.21360.

Abstract

BACKGROUND

Our aim was to report the outcomes of base of tongue cancers treated with chemoradiotherapy.

METHODS

Between 1990 and 2004, 127 patients with stage III or IV base of tongue cancer were treated with chemoradiotherapy on protocol. Indications included nodal involvement, T3/T4 tumors, positive margins, those patients refusing surgery, or were medically inoperable. The most common regimen was paclitaxel (100 mg/m2 on day 1), infusional 5-fluorouracil (600 mg/m2/day × 5 days), hydroxyurea (500 mg prescribed orally [PO] 2 × daily [BID]), and 1.5 Gy twice daily irradiation followed by a 9-day break without treatment.

RESULTS

Median follow-up was 51 months. The median dose to gross tumor was 72.5 Gy (range, 40-75.5 Gy). Five-year locoregional progression-free survival, overall survival, and disease-free survival was 87.0%, 58.2%, and 46.0%, respectively.

CONCLUSION

Concurrent chemoradiotherapy results in promising locoregional control for base of tongue cancer. As distant relapse was common, further investigation of systemic therapy with novel agents may be warranted.

摘要

背景

我们的目的是报告接受放化疗治疗的舌根癌患者的结局。

方法

1990 年至 2004 年间,127 例 III 期或 IV 期舌根癌患者按方案接受放化疗。适应证包括淋巴结受累、T3/T4 肿瘤、切缘阳性、拒绝手术或不能手术的患者。最常见的方案是紫杉醇(第 1 天 100mg/m2)、持续输注氟尿嘧啶(600mg/m2/天×5 天)、羟基脲(500mg 口服,每日 2 次)和 1.5Gy 每日 2 次放疗,然后休息 9 天不治疗。

结果

中位随访时间为 51 个月。大体肿瘤的中位剂量为 72.5Gy(范围 40-75.5Gy)。5 年局部区域无进展生存率、总生存率和无病生存率分别为 87.0%、58.2%和 46.0%。

结论

同期放化疗为舌根癌提供了有前景的局部区域控制。由于远处复发较为常见,可能需要进一步研究新型药物的全身治疗。

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