LoRusso P, Tapazoglou E, Kish J A, Ensley J F, Cummings G, Kelly J, al-Sarraf M
Department of Internal Medicine, Wayne State University School of Medicine, Detroit, MI 48201.
Cancer. 1988 Jul 1;62(1):1-5. doi: 10.1002/1097-0142(19880701)62:1<1::aid-cncr2820620102>3.0.co;2-f.
The role of chemotherapy in the management of patients with cancer of the paranasal sinus has not been defined. An analysis of 24 evaluable patients treated with chemotherapy as part of their overall therapy was performed. There were 16 male patients and eight female patients. Sixteen patients were previously untreated and eight had recurrent disease after surgery and/or radiotherapy. Six of the previously untreated patients had metastatic disease on presentation (four central nervous system (CNS) and two lung), and four recurrent patients had CNS involvement. The majority of patients (78%) had squamous cell carcinoma. The chemotherapy regimens included cisplatin (CDDP), vincristine (VCR), and bleomycin (COB), 5-fluorouracil (5-FU) infusion and CDDP, or 5-FU/CDDP and methotrexate (MTX). All patients had computed tomography (CT) measurable disease. Previously untreated patients underwent surgery and/or radiotherapy postchemotherapy. The overall response rate to chemotherapy for previously untreated patients was 82% (complete response [CR] 44%, partial response [PR] 38%) and for recurrent patients 88% (CR 38%, PR 50%). Predominant toxicities were nausea, vomiting, myelosuppression, mucositis, and renal impairment. The median survival of the previously untreated patients, based on response to chemotherapy, was as follows: CR 21+ months (range, 10+ to 81 months), PR 13.5 months (range, 2 to 21 months), and no response (NR) 3 months (range, 1 to 7 months). The median survival of patients with recurrent disease was as follows: CR 16 months, PR 13.5 months, and NR 5 months. We conclude that patients with paranasal cancers are responsive to CDDP-containing combinations. The role of adjuvant chemotherapy in previously untreated, locally advanced patients needs to be demonstrated by future randomized trials.
化疗在鼻窦癌患者治疗中的作用尚未明确。我们对24例接受化疗作为整体治疗一部分的可评估患者进行了分析。其中男性患者16例，女性患者8例。16例患者此前未接受过治疗，8例患者在手术和/或放疗后出现复发。16例未接受过治疗的患者中有6例初诊时即有转移性疾病（4例中枢神经系统（CNS）转移和2例肺转移），8例复发患者中有4例出现CNS受累。大多数患者（78%）为鳞状细胞癌。化疗方案包括顺铂（CDDP）、长春新碱（VCR）和博来霉素（COB）、5-氟尿嘧啶（5-FU）静脉输注联合CDDP，或5-FU/CDDP联合甲氨蝶呤（MTX）。所有患者均有计算机断层扫描（CT）可测量的疾病。未接受过治疗的患者在化疗后接受手术和/或放疗。未接受过治疗的患者对化疗的总体缓解率为82%（完全缓解[CR]44%，部分缓解[PR]38%），复发患者为88%（CR 38%，PR 50%）。主要毒性反应为恶心、呕吐、骨髓抑制、粘膜炎和肾功能损害。根据化疗反应，未接受过治疗的患者的中位生存期如下：CR为21+个月（范围为10+至81个月），PR为13.5个月（范围为2至21个月），无反应（NR）为3个月（范围为1至7个月）。复发疾病患者的中位生存期如下：CR为16个月，PR为13.5个月，NR为5个月。我们得出结论，鼻窦癌患者对含CDDP的联合化疗有反应。辅助化疗在未接受过治疗的局部晚期患者中的作用需要未来的随机试验来证实。
