Noronha V, Patil V, Joshi A, Muddu V, Bhattacharjee A, Juvekar S, Arya S, Chaturvedi P, Chaukar D, Pai P S, Dcruz A K, Prabhash K
Department of Medical Oncology, Surgical Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India.
Indian J Cancer. 2015 Jan-Mar;52(1):70-3. doi: 10.4103/0019-509X.175604.
Cisplatin and 5 fluorouracil drug combination is inferior to the combination of taxane with these 2 drugs. However, often in clinical practice at our center giving TPF (docetaxel, cisplatin, 5 fluorouracil) is difficult in view of logistics and tolerance issues. In such a scenario, we prefer to use the 2 drugs combination of platinum and taxane. However, no study has addressed whether a 2 drugs combination, which includes taxane is inferior to the 3 drugs combination and which the taxane of choice is in the 2 drugs combination of taxane and platinum.
This is a retrospective analysis of prospectively collected data of patients undergoing induction chemotherapy (IC) in oral cavity cancers from 2010 to 2012. We chose for analysis those patients who had a baseline scan done within 4 weeks of starting therapy and a follow-up scan done within 2 weeks of completion of the second cycle of IC. Response was scored in accordance with RECIST version 1.1. Chi-square analysis was done to compare response rates (RRs) between regimens.
Two hundred and forty-five patients were identified. The median age was 45 years (24-70 years), 208 (84.9%) were male patients, and 154 patients (62.9%) had primary in the Buccal mucosa. The regimens received were TPF 22 (9%), docetaxel + cisplatin 97 (39.6%), paclitaxel + cisplatin 89 (36.3%), docetaxel + carboplatin 16 (6.5%) and paclitaxel + carboplatin 21 (8.6%). The overall RRs were complete response, partial response, stable disease and progressive disease in 4 (1.6%), 56 (22.9%), 145 (59.2%) and 40 (16.3%). The 3 drugs regimen (TPF) had 50% RR as compared to 22% RR with 2 drugs regimen (P = 0.004). Docetaxel containing regimens had 30.3% RR as compared to 17.2% RR with paclitaxel containing regimens (P = 0.094).
TPF has better RR than a 2 drugs taxane-containing regimen and docetaxel leads to a better RR than paclitaxel for IC in locally advanced oral cavity cancers.
顺铂与5-氟尿嘧啶联合用药效果不如紫杉烷与这两种药物的联合用药。然而，在我们中心的临床实践中，由于后勤保障和耐受性问题，给予TPF（多西他赛、顺铂、5-氟尿嘧啶）常常存在困难。在这种情况下，我们更倾向于使用铂类与紫杉烷的两药联合方案。然而，尚无研究探讨包含紫杉烷的两药联合方案是否劣于三药联合方案，以及在紫杉烷与铂类的两药联合方案中哪种紫杉烷为首选。
这是一项对2010年至2012年口腔癌患者诱导化疗（IC）前瞻性收集数据的回顾性分析。我们选择分析那些在开始治疗后4周内进行了基线扫描且在IC第二周期完成后2周内进行了随访扫描的患者。根据RECIST 1.1版对反应进行评分。采用卡方分析比较各治疗方案之间的反应率（RRs）。
共纳入245例患者。中位年龄为45岁（24 - 70岁），男性患者208例（84.9%），154例患者（62.9%）原发于颊黏膜。接受的治疗方案为TPF 22例（9%），多西他赛 + 顺铂97例（39.6%），紫杉醇 + 顺铂89例（36.3%），多西他赛 + 卡铂16例（6.5%），紫杉醇 + 卡铂21例（8.6%）。总体RRs为完全缓解4例（1.6%）、部分缓解56例（22.9%）、病情稳定145例（59.2%）和病情进展40例（16.3%）。三药方案（TPF）的RR为50%，而两药方案的RR为22%（P = 0.004）。含多西他赛的方案RR为30.3%，含紫杉醇的方案RR为17.2%（P = 0.094）。
对于局部晚期口腔癌的诱导化疗，TPF方案的RR优于含紫杉烷的两药方案，且多西他赛导致的RR优于紫杉醇。
