对于人乳头瘤病毒（HPV）阳性和阴性的局部晚期口咽鳞状细胞癌患者，每周化疗联合放疗与高剂量顺铂联合放疗作为器官保留治疗的比较
Weekly chemotherapy with radiation versus high-dose cisplatin with radiation as organ preservation for patients with HPV-positive and HPV-negative locally advanced squamous cell carcinoma of the oropharynx.
作者信息
Dobrosotskaya Irina Y, Bellile Emily, Spector Matthew E, Kumar Bhavna, Feng Felix, Eisbruch Avraham, Wolf Gregory T, Prince Mark E P, Moyer Jeffrey S, Teknos Theodoros, Chepeha Douglas B, Walline Heather M, McHugh Jonathan B, Cordell Kitrina G, Ward P Daniel, Byrd Serena, Maxwell Jessica H, Urba Susan, Bradford Carol R, Carey Thomas E, Worden Francis P
机构信息
Department of Internal Medicine, University of Michigan, Ann Arbor, MI.
出版信息
Head Neck. 2014 May;36(5):617-23. doi: 10.1002/hed.23339. Epub 2013 Jul 2.
BACKGROUND
Optimal treatment for locally advanced squamous cell carcinoma of the oropharynx (SCCOP) is not well defined. Here we retrospectively compare survival and toxicities from 2 different organ preservation protocols.
METHODS
The matched dataset consisted of 35 patients from each trial matched for age, stage, smoking, and tumor human papillomavirus (HPV) status. Patients in the University of Michigan Cancer Center (UMCC) trial 9921 were treated with induction chemotherapy (IC) followed by high-dose cisplatin and radiation in responders or surgery in nonresponders. Patients in the UMCC trial 0221 were treated with weekly carboplatin and paclitaxel and radiation.
RESULTS
Survival was comparable for both studies and did not differ significantly across each trial after stratifying by HPV status. Grade 3 and 4 toxicities were more frequent in UMCC 9921. At 6 months posttreatment, gastrostomy tube (G-tube) dependence was not statistically different.
CONCLUSION
These data suggest that survival outcomes in patients with locally advanced SCCOP are not compromised with weekly chemotherapy and radiation therapy, and such treatment is generally more tolerable.
背景
口咽鳞状细胞癌（SCCOP）局部晚期的最佳治疗方法尚未明确。在此，我们回顾性比较了两种不同器官保留方案的生存率和毒性。
方法
匹配数据集由来自每项试验的35例患者组成，根据年龄、分期、吸烟情况和肿瘤人乳头瘤病毒（HPV）状态进行匹配。密歇根大学癌症中心（UMCC）试验9921中的患者先接受诱导化疗（IC），然后对有反应者给予高剂量顺铂和放疗，对无反应者进行手术。UMCC试验0221中的患者接受每周一次的卡铂和紫杉醇治疗以及放疗。
结果
两项研究的生存率相当，按HPV状态分层后，每项试验中的生存率无显著差异。3级和4级毒性在UMCC 9921中更为常见。治疗后6个月，胃造瘘管（G管）依赖情况无统计学差异。
结论
这些数据表明，局部晚期SCCOP患者采用每周化疗和放疗的生存结果不受影响，且这种治疗通常耐受性更好。
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