Wang Hung-Ming, Hsu Cheng-Lung, Hsieh Chia-Hsun, Fan Kang-Hsing, Lin Chien-Yu, Chang Joseph Tung-Chieh, Huang Shiang-Fu, Chen I-How, Liao Chun-Ta, Ng Shu-Kung
Division of Medical Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan.
Biomed J. 2014 May-Jun;37(3):133-40. doi: 10.4103/2319-4170.117893.
To evaluate the efficacy and adverse events of cisplatin, tegafur, and leucovorin concomitantly with radiotherapy for patients with advanced, non-metastatic squamous cell carcinoma (SCC) of the oropharynx and hypopharynx.
The PTL regimen consisted of cisplatin (P) 50 mg/m 2 on day 1, oral tegafur (T) 800 mg/day plus leucovorin (LV) 60 mg/day on days 1 through 14. It was repeated every 2 weeks through the radiotherapy course. Conventional radiotherapy with 1.8-2.0 Gy/day, 5 days per week, was delivered in a total dose of between 70 and 72 Gy.
Sixty-five patients with stage III or IV of SCC of the head and neck were consecutively treated between May 2002 and November 2005. Forty-six (70.7%) patients had complete response after concomitant chemoradiotherapy (CCRT). With a median follow-up of 54.0 months (range 1-103 months), the 5-year locoregional control, progression-free survival, and overall survival rates were 50.6%, 40.7%, and 59.7%, respectively. Three (4.6%) patients had toxic death during treatment. Fifty-one (80.0%) patients experienced grade 3-4 mucositis which occurred in about 35% of the CCRT duration. The functional preservation rate among post-CCRT complete responders was 93.5% (43/46). The median cisplatin accumulated dosage was 150 mg, and the rate of hearing impairment among the survivors was 7.8%.
CCRT with outpatient-based PTL for advanced SCC of oropharynx and hypopharynx is feasible and has comparative efficacy and acceptable adverse events.
评估顺铂、替加氟和亚叶酸钙同步放疗治疗晚期、非转移性口咽和下咽鳞状细胞癌（SCC）患者的疗效及不良事件。
PTL方案包括第1天给予顺铂（P）50mg/m²，第1至14天口服替加氟（T）800mg/天加亚叶酸钙（LV）60mg/天。在放疗疗程中每2周重复一次。采用常规放疗，每天1.8 - 2.0Gy，每周5天，总剂量为70至72Gy。
2002年5月至2005年11月期间，连续治疗了65例头颈部SCCⅢ期或Ⅳ期患者。46例（70.7%）患者同步放化疗（CCRT）后完全缓解。中位随访54.0个月（范围1 - 103个月），5年局部区域控制率、无进展生存率和总生存率分别为50.6%、40.7%和59.7%。3例（4.6%）患者在治疗期间出现毒性死亡。51例（80.0%）患者发生3 - 4级黏膜炎，约在CCRT疗程的35%时间出现。CCRT后完全缓解者的功能保留率为93.5%（43/46）。顺铂累积中位剂量为150mg，幸存者中听力损害发生率为7.8%。
门诊PTL方案同步放化疗治疗晚期口咽和下咽SCC是可行的，具有相当的疗效和可接受的不良事件。
