多西他赛、顺铂和5-氟尿嘧啶诱导化疗联合顺铂每周同步放化疗用于局部晚期头颈部鳞状细胞癌的可行性和疗效

Feasibility and efficacy of induction docetaxel, cisplatin, and 5-fluorouracil chemotherapy combined with concurrent weekly cisplatin chemoradiotherapy for locally advanced head and neck squamous cell carcinoma.

作者信息

Mizumachi Takatsugu, Homma Akihiro, Kakizaki Tomohiko, Sakashita Tomohiro, Kano Satoshi, Hatakeyama Hiromitsu, Tsuchiya Kazuhiko, Yasuda Koichi, Onimaru Rikiya, Shirato Hiroki, Taguchi Jun, Shimizu Yasushi, Kinoshita Ichiro, Akita Hirotoshi, Fukuda Satoshi

机构信息

Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan,

出版信息

Int J Clin Oncol. 2015 Jun;20(3):431-7. doi: 10.1007/s10147-014-0726-y. Epub 2014 Jul 5.

DOI:10.1007/s10147-014-0726-y

PMID:24993675

Abstract

BACKGROUND

The aim of this study was to evaluate the feasibility of induction docetaxel, cisplatin, and 5-fluorouracil chemotherapy followed by concurrent weekly cisplatin chemoradiotherapy for patients with locally advanced head and neck squamous cell carcinoma (HNSCC).

METHODS

Between 2010 and 2013, 30 patients with Stage IV HNSCC were treated in Hokkaido University Hospital with three cycles of induction chemotherapy (docetaxel 75 mg/m(2) and cisplatin 75 mg/m(2), day 1; and 5-fluorouracil 750 mg/m(2)/day 120 h continuous infusion, every 3 weeks) followed by concurrent weekly cisplatin (40 mg/m(2), on weeks 1, 2, 3, 5, 6 and 7) chemoradiotherapy.

RESULTS

Three courses of induction chemotherapy were performed in 25 patients (83%) with grade 3-4 toxicities during induction chemotherapy observed in 22 patients (73%). The major toxicities were hematologic, with 22 cases (73%) showing grade 3-4 neutropenia. Radiotherapy was completed (70 Gy) in 29 patients (97%), while a total of 19 patients (63%) completed five (13 patients) or six (6 patients) courses of chemotherapy. During concurrent chemoradiotherapy, no grade 4 hematological toxicities were observed. Grade 4 dermatitis was observed in one patient, and grade 3 mucositis was observed in 12 patients. There were no treatment-related deaths during the induction chemotherapy or concurrent chemoradiotherapy. The 1- and 2-year progression-free survival rates and the 1- and 2-year overall survival rates were 86%, 72%, and 89%, 81%, respectively.

CONCLUSION

Sequential therapy composed of induction chemotherapy followed by concurrent weekly cisplatin chemoradiotherapy is feasible, showing encouraging results in patients with locally advanced HNSCC. Concurrent weekly cisplatin chemoradiotherapy following induction chemotherapy appears to be a suitable alternative to three-weekly high-dose cisplatin therapy.

摘要

背景

本研究旨在评估多西他赛、顺铂和5-氟尿嘧啶诱导化疗，随后每周同步进行顺铂放化疗，用于局部晚期头颈部鳞状细胞癌（HNSCC）患者的可行性。

方法

2010年至2013年期间，北海道大学医院对30例IV期HNSCC患者进行了三个周期的诱导化疗（多西他赛75mg/m²和顺铂75mg/m²，第1天；5-氟尿嘧啶750mg/m²/天，持续输注120小时，每3周一次），随后每周同步进行顺铂（40mg/m²，在第1、2、3、5、6和7周）放化疗。

结果

25例患者（83%）完成了三个疗程的诱导化疗，22例患者（73%）在诱导化疗期间出现3-4级毒性反应。主要毒性反应为血液学毒性，22例（73%）出现3-4级中性粒细胞减少。29例患者（97%）完成了放疗（70Gy），共有19例患者（63%）完成了五个疗程（13例）或六个疗程（6例）的化疗。在同步放化疗期间，未观察到4级血液学毒性反应。1例患者出现4级皮炎，12例患者出现3级黏膜炎。诱导化疗或同步放化疗期间无治疗相关死亡病例。1年和2年无进展生存率以及1年和2年总生存率分别为86%、72%和89%、81%。