Calais G, Chapet S, Ruffier-Loubière A, Bernadou G
Clinique d'oncologie-radiothérapie, hôpital Bretonneau, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours cedex 9, France.
Cancer Radiother. 2013 Oct;17(5-6):498-501. doi: 10.1016/j.canrad.2013.06.038. Epub 2013 Sep 4.
Chemotherapy is a part of the combined multimodality treatment for locally advanced head and neck cancers. Concomitant administration with radiation therapy is the standard treatment for these patients. The efficacy of the docetaxel-cisplatinum-5-fluoro-uracil (TPF) regimen compared to the platinum-5-fluoro-uracil (PF) regimen raised the question of whether this treatment could improve the therapeutic results for locally advanced tumours. For larynx preservation, induction chemotherapy using TPF, followed by radiation therapy for good responders is a valid option. However, clinical studies have to be performed to compare this approach to the concomitant radiation therapy-chemotherapy approach using functional endpoints. For locally advanced tumors, despite the superiority of the TPF regimen over the PF, there is no evidence in the literature to support the use of induction chemotherapy prior to concomitant radiation therapy-chemotherapy. Two recent studies (DECIDE, PARADIGM) failed to demonstrate any benefit, but both trials were stopped early because of slow enrollment. Other studies are on going, or with recently finished accrual, will help to shed light on the role of this treatment.
化疗是局部晚期头颈癌联合多模式治疗的一部分。与放射治疗同步给药是这些患者的标准治疗方法。多西他赛-顺铂-5-氟尿嘧啶（TPF）方案与铂-5-氟尿嘧啶（PF）方案相比的疗效引发了这样一个问题，即这种治疗是否能改善局部晚期肿瘤的治疗效果。对于保留喉功能，使用TPF进行诱导化疗，然后对反应良好者进行放射治疗是一种有效的选择。然而，必须进行临床研究，以使用功能终点将这种方法与同步放化疗方法进行比较。对于局部晚期肿瘤，尽管TPF方案优于PF方案，但文献中没有证据支持在同步放化疗之前使用诱导化疗。最近的两项研究（DECIDE、PARADIGM）未能证明有任何益处，但两项试验均因入组缓慢而提前终止。其他研究正在进行中，或最近已完成入组，将有助于阐明这种治疗的作用。
