Davis R K, Gibbs F A, Sapozink M D, Farver M, Harker G
Department of Otolaryngology-Head and Neck Surgery, VA Medical Center, Salt Lake City, UT.
Otolaryngol Head Neck Surg. 1990 Dec;103(6):897-901. doi: 10.1177/019459989010300602.
A combined hyperthermia and chemotherapy approach was used to treat five patients with locally advanced or recurrent squamous cell carcinoma of the head and neck whose tumors had failed to respond to chemotherapy. In two patients, tumor had recurred after initial combined modality therapy (surgery/radiation) and had failed to respond to one course of cisplatin/5-fluorouracil (cisplatin/5-FU) chemotherapy. The three remaining patients were enrolled onto a phase II evaluation of induction chemotherapy with cisplatin/fluorouracil for advanced head and neck carcinomas and had failed to achieve a partial remission after one treatment cycle. Palpable cervical tumors were heated to 40 degrees to 42 degrees C for 30 to 40 minutes, during which time cisplatin (100 mg/m2) was infused intravenously. A 5-day infusion of 5-fluorouracil (1000 mg/m2/d) followed. Despite less than a partial response to previous cisplatin/fluorouracil chemotherapy alone, two patients had complete clinical resolution of the heated tumor volume with two cycles of the combined thermochemotherapy approach. One patient achieved a partial remission with this approach. The remaining two patients died shortly after the initial thermochemotherapy treatment, as a result of progressive tumor growth. The two complete responders were subsequently treated with radiation (1 patient) and radical neck dissection (1 patient) and remained without evidence of disease 2 and 26 months after the completion of therapy, respectively. The toxicity of this combined modality approach was acceptable and appeared to be no greater than had been experienced during earlier treatment with chemotherapy alone. Further studies using a combination of these treatment modalities for locally advanced head and neck carcinomas are warranted.
采用热疗与化疗相结合的方法治疗了5例局部晚期或复发性头颈部鳞状细胞癌患者，这些患者的肿瘤对化疗无反应。2例患者在初始综合治疗（手术/放疗）后肿瘤复发，且对一个疗程的顺铂/5-氟尿嘧啶（顺铂/5-FU）化疗无反应。其余3例患者参加了一项针对晚期头颈部癌的顺铂/氟尿嘧啶诱导化疗的II期评估，在一个治疗周期后未达到部分缓解。可触及的颈部肿瘤被加热至40℃至42℃，持续30至40分钟，在此期间静脉输注顺铂（100mg/m²）。随后进行为期5天的5-氟尿嘧啶（1000mg/m²/天）输注。尽管之前单独使用顺铂/氟尿嘧啶化疗反应不佳，但2例患者通过两个周期的热化疗联合方法使加热的肿瘤体积完全临床消退。1例患者通过该方法获得部分缓解。其余2例患者在初始热化疗治疗后不久因肿瘤进展而死亡。2例完全缓解者随后分别接受了放疗（1例患者）和根治性颈清扫术（1例患者），在治疗完成后分别在2个月和26个月时仍无疾病证据。这种联合治疗方法的毒性是可接受的，并且似乎不大于早期单独化疗时所经历的毒性。有必要进一步研究将这些治疗方式联合用于局部晚期头颈部癌。
