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连续动脉内滴注化疗作为 80 岁或以上老年人口腔鳞状细胞癌的姑息治疗。

Continuous intra-arterial infusion chemotherapy as a palliative treatment for oral squamous cell carcinoma in octogenarian or older patients.

机构信息

Department of Surgery, Kaohsiung Medical University, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.

出版信息

Oral Oncol. 2010 Jul;46(7):559-63. doi: 10.1016/j.oraloncology.2010.04.006. Epub 2010 Jun 9.

Abstract

We intend to determine the potential benefits and analyze the outcomes of regional intra-arterial infusion chemotherapy (IAIC) for the octogenarian and older patients with oral cancer. Eighteen patients with oral squamous cell carcinoma were included. They were 12 males and six females with ages ranging from 80 to 96 years. An implantable port-catheter system was used for catheterization. Using a portable pump, methotrexate was given continuously through the external carotid artery for a mean period of 5.5 days (range, 4-7 days) followed by weekly bolus of low dose (25mg) of methotrexate until the clinical condition was stabilized. During the first week of IAIC, all tumors began to reduce in size. Of them 11 (61%) had a complete clinical response and 7 (39%) achieved a partial clinical response, after a mean follow-up period of 26 months (range, 8-72 months). The one- and three-year survival rates were 87% and 56%, respectively. There were no catheter-related complications. The side effects were mild and tolerable. IAIC might be specially indicated for oral cancer elderly with co-morbidity since a radical surgery or extensive radiotherapy can be avoided, and offers an acceptable palliative treatment in such patients.

摘要

我们旨在确定区域动脉内灌注化疗(IAIC)对 80 岁及以上口腔癌患者的潜在益处,并分析其结果。纳入了 18 例口腔鳞状细胞癌患者,其中男性 12 例,女性 6 例,年龄 80 至 96 岁。采用植入式端口导管系统进行导管插入术。使用便携式输液泵,通过颈外动脉持续输注甲氨蝶呤,平均持续 5.5 天(范围为 4-7 天),随后每周给予低剂量(25mg)甲氨蝶呤推注,直到临床状况稳定。在 IAIC 的第一周,所有肿瘤均开始缩小。其中 11 例(61%)完全临床缓解,7 例(39%)部分临床缓解,平均随访 26 个月(范围 8-72 个月)。1 年和 3 年生存率分别为 87%和 56%。无导管相关并发症。副作用轻微且可耐受。IAIC 可能特别适用于患有合并症的老年口腔癌患者,因为可以避免根治性手术或广泛放疗,并为这些患者提供可接受的姑息治疗。

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