Tomita Masahiko, Matsuyama Hiroshi, Yamazaki Keisuke, Sato Katsuro, Takahashi Sugata
Dept. of Otolaryngology, Nagaoka Red Cross Hospital, Niigata University Faculty of Medicine.
Gan To Kagaku Ryoho. 2012 Jun;39(6):921-5.
Clinical outcomes of 53 patients with oropharyngeal and hypopharyngeal squamous cell carcinoma, treated from January, 2000 to December, 2008 by concurrent chemoradiotherapy of either CDDP or CDGP, plus 5-FU were investigated. Patients were treated with either CDDP (70 mg/m2) or CDGP (100 mg/m2) on day 1 of the chemotherapy regime, with 5-FU (700 mg/m2/day) as a continuous infusion for 5 days. Each regimen was administered as two courses in the first and final weeks of radiotherapy. Radiotherapy was administered at a daily dose of 2 Gy for five days a week, with patients receiving a total of 70 Gy by the end of seven weeks. The primary cancer was located in the oropharynx and hypopharynx in 21 and 32 patients, respectively. Twenty-six patients (49.1%) had stage IVA disease and 10 patients (18.9%) had overall stage I to II disease. Acute adverse events such as pharyngeal mucositis and leucopenia occurred in 49.1% and 43.4% of patients, respectively, and second round chemotherapy was not commenced in 56.6% of patients (n=30) due to significant adverse events. Mean weight loss following treatment was 4.1 kg. After a median follow-up of 30.0 months, 3-year overall survival was 53.0% for advanced carcinoma of the oropharynx and hypopharynx. Five-year overall survival was 46.4%. Patients receiving two courses of chemotherapy had an improved 5-year survival compared to patients receiving one course (67.0% vs 32.8%). Results indicate a significant benefit from two courses of chemotherapy. As such, minimizing the incidence of adverse effects and thereby reducing treatment discontinuation will likely improve overall treatment outcomes.
对2000年1月至2008年12月期间接受顺铂（CDDP）或奈达铂（CDGP）联合5-氟尿嘧啶同步放化疗的53例口咽和下咽鳞状细胞癌患者的临床结局进行了研究。化疗方案第1天，患者接受顺铂（70mg/m²）或奈达铂（100mg/m²）治疗，5-氟尿嘧啶（700mg/m²/天）持续输注5天。每种方案在放疗的第一周和最后一周各进行两个疗程。放疗每周5天，每日剂量为2Gy，7周结束时患者共接受70Gy照射。原发癌位于口咽和下咽的患者分别为21例和32例。26例患者（49.1%）为IVA期疾病，10例患者（18.9%）为I至II期疾病。分别有49.1%和43.4%的患者发生了急性不良事件，如咽黏膜炎和白细胞减少症，56.6%的患者（n=30）因严重不良事件未开始第二轮化疗。治疗后平均体重减轻4.1kg。中位随访30.0个月后，口咽和下咽晚期癌的3年总生存率为53.0%。5年总生存率为46.4%。接受两个疗程化疗的患者5年生存率高于接受一个疗程的患者（67.0%对32.8%）。结果表明两个疗程的化疗有显著益处。因此，尽量减少不良反应的发生率，从而减少治疗中断，可能会改善总体治疗效果。
