Kolarić K, Nagy B, Roth A, Zupanc D, Luetić J, Tometić Z
Department of Medical Oncology, Central Institute for Tumors and Allied Diseases, Zagreb, Yugoslavia.
Oncology. 1988;45(4):276-80. doi: 10.1159/000226622.
The synergistic activity we have observed in vitro in V-79 hamster lung cells after treatment with cis-platinum combined with irradiation, stimulated a pilot study of 31 patients with inoperable locoregionally advanced squamous cell esophageal cancer. The 27 evaluable cases (22 men and 5 women--mean age 59 years) had undergone no prior radiation or cytostatic drug therapy. Histological evidence of the tumor (26 squamous cell, 1 adenocarcinoma) was obtained by endoscopy in all patients before treatment began. The patients were irradiated in two opposite thoracic fields with a total dosage of 3,000-4,000 cGy (200 cGy daily, 1,000 weekly) concurrently with 2 cycles of cis-platinum in the dosage of 30 mg/m2 iv. daily X 4 (120 mg/m2 per cycle). The results showed that cis-platinum combined with radiation showed an evident antitumor activity which included 4 complete clinical remissions and 11 partial remissions with a response rate of 56% (15/27). In two complete responders even a pathologic remission was evident (biopsy specimen) and they are now 16+ and 18+ months free of the disease. The median remission duration has been 8+ months (14+ months in complete responders) and the median survival period for the entire group is 10+ months (for responders 15+ months, p less than 0.05). Toxicity was moderate and reversible, and mainly accounted for radiation mucositis, retrosternal pain and vomiting. A mild bone marrow suppression was observed. In 2 cases esophagotracheal fistulae occurred. The results of this study show that the combination of cis-platinum and radiation might constitute successful palliative or neoadjuvant treatment for squamous cell esophageal cancer.
我们观察到顺铂联合放疗后在体外V - 79仓鼠肺细胞中具有协同活性，这激发了一项针对31例无法手术的局部晚期食管鳞状细胞癌患者的初步研究。27例可评估病例（22例男性和5例女性，平均年龄59岁）之前未接受过放疗或细胞毒性药物治疗。在开始治疗前，所有患者均通过内镜检查获得肿瘤的组织学证据（26例鳞状细胞癌，1例腺癌）。患者在两个相对的胸部野接受照射，总剂量为3000 - 4000 cGy（每日200 cGy，每周1000 cGy），同时静脉注射顺铂2个周期，剂量为每日30 mg/m²×4（每周期120 mg/m²）。结果显示，顺铂联合放疗显示出明显的抗肿瘤活性，包括4例完全临床缓解和11例部分缓解，缓解率为56%（15/27）。在2例完全缓解者中甚至出现了病理缓解（活检标本），他们目前已无病生存16个月和18个月以上。中位缓解持续时间为8个月以上（完全缓解者为14个月以上），整个组的中位生存期为10个月以上（缓解者为15个月以上，p<0.05）。毒性为中度且可逆，主要表现为放射性粘膜炎、胸骨后疼痛和呕吐。观察到轻度骨髓抑制。2例发生了食管气管瘘。本研究结果表明，顺铂与放疗联合可能构成食管鳞状细胞癌成功的姑息性或新辅助治疗方法。
