Department of Clinical Oncology, St. James's Institute of Oncology, Leeds, UK.
Clin Oncol (R Coll Radiol). 2013 Nov;25(11):647-53. doi: 10.1016/j.clon.2013.07.007. Epub 2013 Aug 13.
The role of induction chemotherapy (ICT) for head and neck squamous cell carcinoma (HNSCC) is controversial. The aim of the study was to assess the benefit of ICT with docetaxel, cisplatin and 5-fluorouracil (5-FU) (TPF) when combined with concurrent cisplatin chemoradiotherapy (CRT) for HNSCC.
Patients with HNSCC treated between January 2005 and December 2010 with radical intent with either TPF or cisplatin and 5-FU (PF) ICT and documented intention to proceed with concurrent cisplatin CRT were identified retrospectively. The use and choice of ICT regimen was at the clinician's discretion. In total, 68 patients treated with TPF were identified and were matched for T and N stage and tumour site to 68 patients treated with PF. A survival analysis was carried out using Kaplan-Meier and the Cox proportional hazards model.
The median follow-up was 29.9 versus 36.3 months for the TPF and PF groups, respectively. Three year locoregional relapse-free survival (RFS), distant RFS, RFS, cancer-specific survival and overall survival rates for the TPF and PF groups were 84.2, 91.6, 82.6, 81.3 and 74.9% versus 73.7, 84.9, 71.9, 72.1 and 62.9%, respectively. On multivariate analysis, treatment with TPF predicted for improved locoregional RFS (P = 0.03) and overall survival (P = 0.05).
The addition of docetaxel to a cisplatin doublet ICT regimen before concurrent CRT may improve disease control for locally advanced HNSCC.
诱导化疗（ICT）对头颈部鳞状细胞癌（HNSCC）的作用存在争议。本研究旨在评估多西紫杉醇、顺铂和 5-氟尿嘧啶（5-FU）（TPF）联合顺铂同期放化疗（CRT）用于 HNSCC 的疗效。
回顾性分析 2005 年 1 月至 2010 年 12 月接受根治性治疗的 HNSCC 患者，这些患者接受了 TPF 或顺铂和 5-FU（PF）ICT，并有接受同期顺铂 CRT 的记录意向。ICT 方案的使用和选择由临床医生自行决定。共确定了 68 例接受 TPF 治疗的患者，并与 68 例接受 PF 治疗的患者在 T 期和 N 期以及肿瘤部位上进行匹配。采用 Kaplan-Meier 法和 Cox 比例风险模型进行生存分析。
TPF 和 PF 组的中位随访时间分别为 29.9 个月和 36.3 个月。TPF 和 PF 组的 3 年局部区域无复发生存率（RFS）、远处 RFS、RFS、癌症特异性生存率和总生存率分别为 84.2%、91.6%、82.6%、81.3%和 74.9%和 73.7%、84.9%、71.9%、72.1%和 62.9%。多变量分析显示，TPF 治疗可预测局部区域 RFS（P = 0.03）和总生存率（P = 0.05）的改善。
在同期 CRT 前，将多西紫杉醇加入顺铂二联 ICT 方案中可能会改善局部晚期 HNSCC 的疾病控制。
