Univ.-HNO-Klinik, Universitätsmedizin Mannheim, D-68167 Mannheim, Germany.
Oncol Rep. 2010 Nov;24(5):1213-6. doi: 10.3892/or_00000974.
Squamous cell carcinoma of the head and neck (SCCHN) presents at a locally advanced (LA) stage in many patients. Chemotherapy, which is one fundamental therapy mode for local disease control of inoperable disease or if organ preservation is desired, has become an important factor of first line treatment regimens either during or prior to radiotherapy (RT). Patients with locoregionally advanced inoperable, recurrent or metastatic disease still have a poor prognosis, which enforces the need for new treatment approaches and new drug therapies, adjusted to the different settings of the disease. One innovative progress for this collective of patients with locally advanced tumor was the implementation of Docetaxel in chemotherapeutic regimes in optimal combination with concurrent chemoradiotherapy or in neoadjuvant setting of induction phase treatment. Docetaxel combined with the conventional chemotherapy regimen, containing Cisplatin and 5-Fluorouracil (TPF), is now acknowledged as being the gold standard of induction treatment. Various studies suggest survival advantage due to the induction chemotherapy (ICT) followed by chemoradiotherapy, which is known as sequential therapy, over chemoradiotherapy alone. In contrast to prevailing studies we administered Docetaxel, Carboplatin and 5-FU within the frame-work of induction chemotherapy instead of conventional use of Cisplatin for five patients with locoregionally advanced HNSCC. The clinical progress was evaluated through cross section imaging (computer tomography/MRI) prior and after ICT and classified following the RECIST criteria. Due to a very small collective of patient and the administration of Carboplatin instead of Cisplatin in this study, it was not possible to document the the efficacy of ICT (TPF) concerning survival advantage in patient with locoregionally advanced head and neck tumors. Further studies with an extended collective of patients are neccessary.
头颈部鳞状细胞癌（SCCHN）在许多患者中表现为局部晚期（LA）阶段。化疗是不可手术疾病或如果需要保留器官的局部疾病控制的一种基本治疗模式，已成为一线治疗方案的重要因素，无论是在放疗（RT）期间还是之前。局部晚期不可手术、复发或转移性疾病的患者预后仍然较差，这需要新的治疗方法和新的药物治疗方法，以适应疾病的不同情况。对于这组局部晚期肿瘤患者，一个创新进展是将多西紫杉醇纳入化疗方案中，与同期放化疗或新辅助诱导期治疗相结合。多西紫杉醇与含有顺铂和 5-氟尿嘧啶（TPF）的常规化疗方案联合使用，现在被认为是诱导治疗的金标准。各种研究表明，由于诱导化疗（ICT）继以放化疗（称为序贯治疗）后，与单独放化疗相比，生存优势。与流行的研究不同，我们在诱导化疗中使用多西紫杉醇、卡铂和 5-FU 代替常规使用顺铂治疗五例局部晚期头颈部鳞癌患者。通过 ICT 前后的横截面成像（计算机断层扫描/MRI）评估临床进展，并根据 RECIST 标准进行分类。由于患者的小样本量和本研究中使用卡铂代替顺铂，因此无法证明 ICT（TPF）在局部晚期头颈部肿瘤患者中的生存优势的疗效。需要进一步扩大患者群体的研究。
