Peyrade F, Saâda E, Benezery K, Hebert C, Dassonville O
Département d'oncologie médicale, centre Antoine-Lacassagne, Nice cedex 2, France.
Cancer Radiother. 2011 Oct;15(6-7):460-5. doi: 10.1016/j.canrad.2011.07.233. Epub 2011 Aug 31.
The standard treatment for head and neck inoperable squamous cell carcinoma is an association of radiotherapy and platinum. However, only one patient out of three remains alive five years after diagnosis. The interest in induction chemotherapy was renewed by the introduction of taxanes combined with cisplatinum and 5-fluoro-uracile. The triple association taxane-cisplatinum-5-fluoro-uracile yielded improved survival when compared to cisplatinum-5-fluoro-uracile. Wider use of taxane-cisplatinum-5-fluoro-uracile is limited by its toxicity and the lack of randomized comparison with a concomitant chemoradiotherapy scheme including optimal doses of platinum. Until the results of new phase III trials are published, the choice between induction chemotherapy followed by concomitant chemoradiotherapy or concomitant chemoradiotherapy alone has to be made on an individualized basis, taking into account the patient's medical condition, the ability of the medical team to deal with intensive treatment regimens, and the clinical/pathological characteristics of the tumour.
头颈部不可手术切除的鳞状细胞癌的标准治疗方法是放疗与铂类药物联合使用。然而，在诊断后的五年里，每三名患者中只有一人存活。随着紫杉烷类药物与顺铂和5-氟尿嘧啶联合使用，诱导化疗再次受到关注。与顺铂-5-氟尿嘧啶相比，紫杉烷-顺铂-5-氟尿嘧啶三联疗法提高了生存率。紫杉烷-顺铂-5-氟尿嘧啶的广泛应用受到其毒性的限制，并且缺乏与包含最佳铂剂量的同步放化疗方案的随机对照比较。在新的III期试验结果公布之前，必须根据个体情况做出选择，是先进行诱导化疗然后进行同步放化疗，还是仅进行同步放化疗，同时要考虑患者的病情、医疗团队处理强化治疗方案的能力以及肿瘤的临床/病理特征。
