Picker H, Zingerle N, Böheim K, Lochs A, Spoendlin H
Arch Otorhinolaryngol. 1986;243(5):324-8. doi: 10.1007/BF00460211.
We examined the influence of induction chemotherapy integrated with surgery and postoperative radiotherapy on 5-year treatment results of 107 patients suffering from advanced head and neck carcinomas. The chemotherapy regimen consisted of one to three cycles of a combination of cisplatin, methotrexate and bleomycin. The overall response rate to induction chemotherapy was 58% with a 26% complete response rate. Using actuarial life tables, survival was 44% for all patients. The initial tumor stages were found to be predictive for patients' responses to chemotherapy as well as for their survivals. The overall response rate was 65% for T-3 tumors vs 29% for T-4 tumors. Five-year survival was 54% for T-3 vs 24% for T-4 tumors. The other predictive factor for survival was response to chemotherapy. Five-year survival was 73% for those patients achieving a complete response vs 17%-37% for patients with any residual disease after drug treatment. Since a favorable response to chemotherapy was strongly associated with a lesser T-stage as well as with significantly better survival of patients in our study, we conclude that induction chemotherapy may best benefit those patients with smaller tumors. Our findings show that a complete response to chemotherapy can also serve as a good prognostic sign, although an a priori better prognosis is still associated with patients who have smaller tumors.
我们研究了诱导化疗联合手术及术后放疗对107例晚期头颈癌患者5年治疗结果的影响。化疗方案包括顺铂、甲氨蝶呤和博来霉素联合应用1至3个周期。诱导化疗的总缓解率为58%，完全缓解率为26%。采用精算生命表，所有患者的生存率为44%。发现初始肿瘤分期可预测患者对化疗的反应及其生存率。T-3期肿瘤的总缓解率为65%，而T-4期肿瘤为29%。T-3期肿瘤的5年生存率为54%，T-4期肿瘤为24%。生存的另一个预测因素是对化疗的反应。完全缓解的患者5年生存率为73%，而药物治疗后有任何残留病灶的患者为17%-37%。由于在我们的研究中，对化疗的良好反应与较低的T分期以及患者明显更好的生存率密切相关，我们得出结论，诱导化疗可能对肿瘤较小的患者最有益。我们的研究结果表明，对化疗的完全缓解也可作为一个良好的预后指标，尽管先验的较好预后仍与肿瘤较小的患者相关。
