Ghosh Saptarshi, Rao Pamidimukkala Brahmananda, Kumar P Ravindra, Manam Surendra
Department of Radiotherapy, GSL Cancer Hospital, GSL Medical College, Rajahmundry, India E-mail :
Asian Pac J Cancer Prev. 2015;16(16):7309-13. doi: 10.7314/apjcp.2015.16.16.7309.
The organ preservation approach of choice for the treatment of locally advanced head and neck cancers is concurrent chemoradiation with three weekly high doses of cisplatin. Although this is an efficacious treatment policy, it has high acute systemic and mucosal toxicities, which lead to frequent treatment breaks and increased overall treatment time. Hence, the current study was undertaken to evaluate the efficacy of concurrent chemoradiation using 40 mg/m2 weekly cisplatin.
This is a single institutional retrospective study including the data of 266 locally advanced head and neck cancer patients who were treated with concurrent chemoradiation using 40 mg/m2 weekly cisplatin from January 2012 to January 2014. A p-value of < 0.05 was taken to be significant statistically for all purposes in the study.
The mean age of the study patients was 48.8 years. Some 36.1% of the patients had oral cavity primary tumors. The mean overall treatment time was 57.2 days. With a mean follow up of 15.2 months for all study patients and 17.5 months for survivors, 3 year local control, locoregional control and disease free survival were seen in 62.8%, 42.8% and 42.1% of the study patients. Primary tumor site, nodal stage of disease, AJCC stage of the disease and number of cycles of weekly cisplatin demonstrated statistically significant correlations with 3 year local control, locoregional control and disease free survival.
Concurrent chemoradiotherapy with moderate dose weekly cisplatin is an efficacious treatment regime for locally advanced head and neck cancers with tolerable toxicity which can be used in developing countries with limited resources.
治疗局部晚期头颈癌的首选器官保存方法是同步放化疗，每周使用三次高剂量顺铂。尽管这是一种有效的治疗策略，但它具有较高的急性全身毒性和黏膜毒性，导致频繁的治疗中断和总治疗时间延长。因此，本研究旨在评估每周使用40mg/m²顺铂同步放化疗的疗效。
这是一项单机构回顾性研究，纳入了2012年1月至2014年1月期间接受每周40mg/m²顺铂同步放化疗的266例局部晚期头颈癌患者的数据。在本研究中，所有目的的p值<0.05均被视为具有统计学意义。
研究患者的平均年龄为48.8岁。约36.1%的患者患有口腔原发性肿瘤。平均总治疗时间为57.2天。所有研究患者的平均随访时间为15.2个月，幸存者为17.5个月，62.8%、42.8%和42.1%的研究患者实现了3年局部控制、区域控制和无病生存。原发肿瘤部位、疾病的淋巴结分期、疾病的美国癌症联合委员会（AJCC）分期以及每周顺铂的周期数与3年局部控制、区域控制和无病生存显示出统计学上的显著相关性。
每周使用中等剂量顺铂同步放化疗是治疗局部晚期头颈癌的一种有效治疗方案，毒性可耐受，可用于资源有限的发展中国家。
