Guenne Clémence, Fayette Jérôme, Cosmidis Alain, Fuchsmann Carine, Tartas Sophie, Favrel Véronique, Céruse Philippe
Head and Neck Surgery Department, Lyon-I University, Hospices Civils de Lyon, Lyon Sud Hospital, Pierre-Bénite, France.
Medicine Department, Lyon-I University, Centre Léon Bérard, Lyon, France.
Drug Des Devel Ther. 2014 Dec 12;8:2549-53. doi: 10.2147/DDDT.S70451. eCollection 2014.
No specific study has focused on patients with metastatic squamous cell carcinoma of the head and neck (SCCHN) at diagnosis. Due to high response rates of induction chemotherapy in chemo-naïve patients with localized disease, their prognosis should be better than patients with recurrent disease.
From January 1, 2008 to July 1, 2012, we retrospectively collected all patients' records with SCCHN diagnosed as metastatic. Patients, disease, treatment and its results were analyzed. Survival was calculated using the Kaplan-Meier method.
Of the 749 new patients treated for SCCHN in our institution, 16 (2.1%) were metastatic at diagnosis, of whom five had cytological results to prove it. Six patients died before treatment or had palliative care and ten received initial chemotherapy and then surgery and/or radiotherapy according to the primary response. Four patients treated with first-line chemotherapy with docetaxel-5FU-cisplatin (TPF) showed a complete response of metastatic lesions allowing locoregional treatment. The overall survival at 1 year and 3 years was 50% and 24%, respectively. The median survival was 7 months (1-72 months). Seven patients (43.7%) had a higher survival at 12 months, including five (31.5%) who are still alive without recurrence with a mean follow-up of 30 months. There was a significant difference in overall survival (P<0.01) between patients who had chemotherapy with TPF versus other therapeutic protocols. The median survival of patients with lung metastases only was 15 months (1-72 months), significantly higher than that of patients with liver and/or bone localizations, which was 2 months (1-9 months).
Patients with metastatic SCCHN treated by TPF followed by multimodal treatment could achieve long survival.
目前尚无专门针对初诊时为转移性头颈部鳞状细胞癌（SCCHN）患者的研究。由于诱导化疗对局部疾病的初治患者缓解率较高，他们的预后应优于复发性疾病患者。
2008年1月1日至2012年7月1日，我们回顾性收集了所有诊断为转移性SCCHN患者的记录。对患者、疾病、治疗及其结果进行了分析。采用Kaplan-Meier法计算生存率。
在我们机构接受治疗的749例新诊断SCCHN患者中，16例（2.1%）初诊时为转移性，其中5例有细胞学结果证实。6例患者在治疗前死亡或接受姑息治疗，10例接受初始化疗，然后根据主要反应接受手术和/或放疗。4例接受多西他赛-5氟尿嘧啶-顺铂（TPF）一线化疗的患者转移性病变完全缓解，从而可以进行局部区域治疗。1年和3年总生存率分别为50%和24%。中位生存期为7个月（1 - 72个月）。7例患者（43.7%）12个月时生存率较高，其中5例（31.5%）仍存活且无复发，平均随访30个月。接受TPF化疗的患者与其他治疗方案患者的总生存率存在显著差异（P<0.01）。仅发生肺转移患者的中位生存期为15个月（1 - 72个月），显著高于有肝和/或骨转移患者的2个月（1 - 9个月）。
接受TPF化疗后进行多模式治疗的转移性SCCHN患者可实现长期生存。
