Ahn Dongbin, Sohn Jin Ho, Kim Jae Hyug, Lee Jeong Eun, Park Shin Hyung, Kim Jae Chul
Corresponding author: Jin Ho Sohn, MD, PhD, Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Kyungpook National University, 50 Samduck 2-Ga, Jung-Gu, Daegu 700-712, Republic of Korea. Email:
Ear Nose Throat J. 2016 Feb;95(2):E34-42. doi: 10.1177/014556131609500210.
A combination of 5-fluorouracil and cisplatin (FP regimen) is widely used as a standard treatment for head and neck cancer. Recently, capecitabine has received increased attention. We conducted a retrospective study to compare the efficacy and safety of the FP regimen with that of the "XP regimen," which entails concurrent chemoradiotherapy (CCRT) with capecitabine and cisplatin, in patients with resectable laryngohypopharyngeal squamous cell carcinoma (SCC). We retrospectively reviewed the records of 71 patients-67 men and 4 women, mean age 63.1 years-who had undergone CCRT from August 2004 through March 2010 as a primary treatment for resectable laryngohypopharyngeal SCC. There were 19 patients in the FP group and 52 in the XP group. With regard to chemotherapy morbidity, the XP group had less need for healthcare resources and fewer delays in treatment due to toxicity. After CCRT, a higher (but not statistically significant) rate of complete response was observed in the XP group than in the FP group (71.2 vs. 57.9%; p = 0.291); the XP group also had a better, although not significant, response among patients with neck metastases (67.7 vs. 30%; p = 0.063). During follow-up (mean: 34.8 ± 30.6 mo), recurrence rates were 25.6% in the XP group and 21.4% in the FP group-again, not a statistically significant difference (p = 0.745). At the time of the final follow-up, 20 of the 71 patients (28.2%) had died of disease. Compared with the FP group, the XP group had a significantly lower incidence of disease-specific death (21.2 vs. 47.4% respectively; p = 0.030). However, the Kaplan-Meier method identified no significant difference between the two groups in the 3-year survival rate (69.6 vs. 63.2%; p = 0.263). Overall toxicities and grade 3 or 4 toxicities (with the exception of hand-foot syndrome) were generally far less common in the XP group, with statistical significance identified for patients who experienced anemia, nausea, and vomiting. On the basis of our experience, we conclude that the results of the XP regimen were comparable to those of the FP regimen for CCRT in patients with resectable laryngohypopharyngeal SCC in terms of treatment efficacy, toxicity, and patient convenience.
5-氟尿嘧啶和顺铂联合方案（FP方案）被广泛用作头颈部癌的标准治疗方法。最近，卡培他滨受到了更多关注。我们进行了一项回顾性研究，比较FP方案与“XP方案”（即卡培他滨和顺铂同步放化疗[CCRT]）在可切除喉下咽鳞状细胞癌（SCC）患者中的疗效和安全性。我们回顾性分析了2004年8月至2010年3月期间接受CCRT作为可切除喉下咽SCC主要治疗方法的71例患者的记录，其中男性67例，女性4例，平均年龄63.1岁。FP组有19例患者，XP组有52例患者。在化疗不良反应方面，XP组对医疗资源的需求较少，因毒性导致的治疗延误也较少。CCRT后，XP组的完全缓解率高于FP组（71.2%对57.9%；p = 0.291），但差异无统计学意义；在有颈部转移的患者中，XP组的缓解情况也较好，尽管差异不显著（67.7%对30%；p = 0.063）。在随访期间（平均：34.8 ± 30.6个月），XP组的复发率为25.6%，FP组为21.4%，同样差异无统计学意义（p = 0.745）。在最后一次随访时，71例患者中有20例（28.2%）死于疾病。与FP组相比，XP组的疾病特异性死亡率显著较低（分别为21.2%和47.4%；p = 0.030）。然而，Kaplan-Meier方法显示两组的3年生存率无显著差异（69.6%对63.2%；p = 0.263）。总体毒性以及3级或4级毒性（手足综合征除外）在XP组通常远没有那么常见，在经历贫血、恶心和呕吐的患者中差异具有统计学意义。根据我们的经验，我们得出结论，就治疗疗效、毒性和患者便利性而言，XP方案与FP方案在可切除喉下咽SCC患者的CCRT中效果相当。
