T2-4N0期舌癌的逆行超选择性动脉内化疗与每日同步放疗：隐匿性颈部转移的控制
Retrograde superselective intra-arterial chemotherapy and daily concurrent radiotherapy for T2-4N0 tongue cancer: control of occult neck metastasis.
作者信息
Minamiyama Shuhei, Mitsudo Kenji, Hayashi Yuichiro, Iida Masaki, Iwai Toshinori, Nakashima Hideyuki, Oguri Senri, Ozawa Tomomichi, Koizumi Toshiyuki, Hirota Makoto, Kioi Mitomu, Tohnai Iwai
机构信息
Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan; Department of Dentistry and Oral Surgery, Yamato Municipal Hospital, Yamato City, Kanagawa, Japan.
Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan.
出版信息
Oral Surg Oral Med Oral Pathol Oral Radiol. 2017 Jul;124(1):16-23. doi: 10.1016/j.oooo.2017.02.004. Epub 2017 Feb 21.
OBJECTIVE
To evaluate the therapeutic results and control of occult neck metastasis in patients with T2-4N0 oral tongue squamous cell carcinoma treated with retrograde superselective intra-arterial chemotherapy and daily concurrent radiotherapy.
STUDY DESIGN
Forty-two patients with T2-4N0 tongue cancer (17 with late T2; 13 with T3; and 12 with T4a disease, M0) were treated with intra-arterial chemoradiotherapy. Treatment consisted of retrograde superselective intra-arterial chemotherapy (docetaxel 50-70 mg/m, cisplatin 125-175 mg/m) and daily concurrent radiotherapy (50-70 Gy) for 5-7 weeks.
RESULTS
The median follow-up for all patients was 46.5 months (range, 8-105 months). Primary-site complete response was achieved in 42 of 42 cases (100%). Three-year overall survival, progression-free survival, and local control rates were 85.0%, 77.8%, and 91.7%, respectively. Delayed neck metastasis was detected in 5 of 42 cases (11.9%). Grade 3 or 4 toxic changes included oral mucositis in 92.9%, neutropenia in 21.4%, and thrombocytopenia in 4.8%. Grade 3 toxicities included anemia in 16.7%, radiation dermatitis in 9.5%, nausea in 4.8%, and fever in 2.4%.
CONCLUSIONS
Retrograde superselective intra-arterial chemotherapy for T2-4N0 tongue cancer provided good overall survival and local control rates and was effective for occult neck metastasis.
目的
评估逆行超选择性动脉内化疗联合每日同步放疗治疗T2 - 4N0期口腔舌鳞状细胞癌患者的治疗效果及隐匿性颈部转移的控制情况。
研究设计
42例T2 - 4N0期舌癌患者（17例为晚期T2；13例为T3；12例为T4a期疾病，M0）接受动脉内放化疗。治疗包括逆行超选择性动脉内化疗（多西他赛50 - 70mg/m²，顺铂125 - 175mg/m²）和每日同步放疗（50 - 70Gy），持续5 - 7周。
结果
所有患者的中位随访时间为46.5个月（范围8 - 105个月）。42例患者中有42例（100%）原发部位达到完全缓解。三年总生存率、无进展生存率和局部控制率分别为85.0%、77.8%和91.7%。42例患者中有5例（11.9%）检测到延迟性颈部转移。3级或4级毒性反应包括口腔黏膜炎92.9%、中性粒细胞减少21.4%、血小板减少4.8%。3级毒性反应包括贫血16.7%、放射性皮炎9.5%、恶心4.8%、发热2.4%。
结论
逆行超选择性动脉内化疗治疗T2 - 4N0期舌癌可提供良好的总生存率和局部控制率，对隐匿性颈部转移有效。
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