Baykara Meltem, Buyukberber Suleyman, Ozturk Banu, Coskun Ugur, Unsal Diclehan Kilic, Demirci Umut, Dane Faysal, Kaplan Muhammet Ali, Bora Huseyin, Benekli Mustafa
Department of Medical Oncology, Sakarya University Training and Research Hospital, Sakarya, Turkey.
Asian Pac J Cancer Prev. 2013;14(4):2557-61. doi: 10.7314/apjcp.2013.14.4.2557.
Chemoradiation (CRT) using cisplatin-based regimens has become the standard of care in the treatment of squamous cell head and neck cancers (SCHNC). The impact of taxanes as radiosensitizing agents with concurrent CRT regimens is unknown. We therefore retrospectively evaluated the efficacy and tolerability of a weekly cisplatin+docetaxel combination with CRT in locally advanced SCHNC.
Sixty-six patients with locally advanced SCHNC (39.4% stage IV, 53% stage III, and 7.6% stage II) were assessed retrospectively. Total radiation dose to the PTV of gross disease (primary and/or node) was 70 Gy/ 35 fractions, 5 fractions per week. Minimum doses of 60 Gy and 50 Gy were administered to PTVs of elective high risk and low risk disease, respectively. Chemotherapy (CT) consisted of weekly cisplatin (20 mg/m2) +docetaxel (20 mg/m2) concurrently with RT.
The median age of the patients was 58 years (range, 32-77). Objective response rate was 83.3%. The 2-year progression-free survival (PFS) and overall survival (OS) were 75.7% and 78.3%, respectively. The most common grade 3 and 4 toxicities were mucositis (36.4%), nausea and vomiting (12.1%), neutropenia (4.5%).
Weekly cisplatin and docetaxel concurrent with RT for locally advanced SCHNC was found tolerable with high efficacy.
使用基于顺铂的方案进行放化疗（CRT）已成为治疗头颈部鳞状细胞癌（SCHNC）的标准治疗方法。紫杉烷类作为同步CRT方案的放射增敏剂的影响尚不清楚。因此，我们回顾性评估了每周顺铂+多西他赛联合CRT治疗局部晚期SCHNC的疗效和耐受性。
回顾性评估66例局部晚期SCHNC患者（39.4%为IV期，53%为III期，7.6%为II期）。对大体肿瘤（原发灶和/或淋巴结）的计划靶体积（PTV）的总放射剂量为7周内给予70 Gy/35次，每周5次。对选择性高风险和低风险疾病的PTV分别给予最低60 Gy和50 Gy的剂量。化疗（CT）包括每周顺铂（20 mg/m²）+多西他赛（20 mg/m²）与放疗同步进行。
患者的中位年龄为58岁（范围32 - 77岁）。客观缓解率为83.3%。2年无进展生存期（PFS）和总生存期（OS）分别为75.7%和78.3%。最常见的3级和4级毒性反应为黏膜炎（36.4%）、恶心和呕吐（12.1%）、中性粒细胞减少（4.5%）。
发现每周顺铂和多西他赛与放疗同步用于局部晚期SCHNC耐受性良好且疗效高。
