Johnson J T, Myers E N, Mayernik D G, Nolan T A, Sigler B A, Wagner R L
Eye and Ear Hospital, Pittsburgh, Penn. 15213.
Laryngoscope. 1990 Jun;100(6):590-2. doi: 10.1288/00005537-199006000-00007.
A trial of surgery, irradiation, and adjuvant chemotherapy was offered to patients with extracapsular spread of squamous cell carcinoma in cervical metastases. Following surgery and irradiation, methotrexate, 5-fluorouracil, and leucovorin were administered 18 times over 6 months. Fifty patients undertook chemotherapy, while 47 patients declined further therapy. Comparison of the two groups according to stage, site, and Karnofsky performance status demonstrated no significant differences. The number of nodes encountered and the number and percentage of nodes with extracapsular spread were similar in the two groups. The minimum 5-year adjusted survival for patients undergoing adjuvant chemotherapy is 54% (20 of 37 patients), while survival of patients who failed to undertake adjuvant chemotherapy was 17% (5 of 30 patients). These data suggest the efficacy of methotrexate-5-fluorouracil adjuvant chemotherapy and support the need for a prospective randomized clinical trial.
对于宫颈转移灶出现鳞状细胞癌包膜外扩散的患者，提供了手术、放疗及辅助化疗的试验。手术和放疗后，在6个月内给予甲氨蝶呤、5-氟尿嘧啶和亚叶酸钙18次。50例患者接受了化疗，而47例患者拒绝进一步治疗。根据分期、部位和卡诺夫斯基功能状态对两组进行比较，未发现显著差异。两组中遇到的淋巴结数量以及出现包膜外扩散的淋巴结数量和百分比相似。接受辅助化疗的患者的最低5年校正生存率为54%（37例患者中的20例），而未接受辅助化疗的患者的生存率为17%（30例患者中的5例）。这些数据表明甲氨蝶呤-5-氟尿嘧啶辅助化疗的疗效，并支持进行前瞻性随机临床试验的必要性。
