Christie NHS Foundation Trust, Manchester, UK.
Chemotherapy. 2013;59(1):1-7. doi: 10.1159/000348816. Epub 2013 Apr 25.
Cisplatin/5-fluorouracil (5-FU) is an accepted palliative chemotherapy treatment for head and neck squamous cell carcinoma, improving quality of life but not overall survival. Capecitabine in place of 5-FU removes the morbidity of an infusional regime with potential benefit in patient well-being. This study looks at outcomes for cisplatin plus capecitabine (PX) outside of a trial setting.
Consecutive patients receiving this treatment in a single centre were retrospectively analysed. Cisplatin (mean dose 75 mg/m²) was given on day 1 of a 3-week cycle and capecitabine (mean dose 808 mg/m² twice daily) on days 1-14, for up to 6 cycles.
Sixty-five patients (median age 58.6 years) received a median of 4 cycles of chemotherapy. The overall response rate was 30.7%, with a median overall survival of 7.3 months. Treatment was well tolerated with a 10.7% grade 3 and a 1.5% grade 4 neutropenia rate, with no other grade 4 toxicities. One patient died of neutropenic sepsis whilst on treatment. Twenty-seven percent of patients stopped treatment early due to chemotherapy-related side effects.
PX is well tolerated outside the trial setting with outcomes similar to historical published literature. Ease of administration and benefit to patient convenience make it an attractive alternative to standard palliative treatment.
顺铂/5-氟尿嘧啶（5-FU）是头颈部鳞状细胞癌的一种公认的姑息性化疗治疗方法，可提高生活质量，但不能提高总生存率。用卡培他滨替代 5-FU 可避免输注方案的发病率，并可能改善患者的生活质量。本研究探讨了在临床试验之外使用顺铂加卡培他滨（PX）的治疗效果。
对在单一中心接受该治疗的连续患者进行回顾性分析。顺铂（平均剂量 75mg/m²）在 3 周周期的第 1 天给药，卡培他滨（平均剂量 808mg/m²，每日 2 次）在第 1-14 天给药，最多 6 个周期。
65 例患者（中位年龄 58.6 岁）接受了中位数为 4 个周期的化疗。总缓解率为 30.7%，中位总生存期为 7.3 个月。治疗耐受性良好，中性粒细胞减少症的发生率为 10.7%（3 级）和 1.5%（4 级），无其他 4 级毒性。1 例患者在治疗期间死于中性粒细胞减少性脓毒症。27%的患者因化疗相关副作用而提前停止治疗。
PX 在临床试验之外具有良好的耐受性，其疗效与历史文献相似。该方案给药方便，且能使患者受益，因此是标准姑息治疗的一种有吸引力的替代方案。
