Chen Chien-Chih, Lin Jin-Ching, Chen Kuan-Wen
Department of Radiation Oncology, Taichung Veterans General Hospital, Taiwan, Republic of China; Ph.D. Program in Translational Medicine, National Chung-Hsing University, Taiwan, Republic of China.
Department of Radiation Oncology, Taichung Veterans General Hospital, Taiwan, Republic of China; Department of Medicine, School of Medicine, National Yang-Ming University, Taiwan, Republic of China.
Oral Oncol. 2017 Jun;69:11-14. doi: 10.1016/j.oraloncology.2017.03.017. Epub 2017 Apr 3.
To compare the treatment outcomes and toxicity of both cisplatin and cisplatin plus 5FU chemotherapy in head and neck cancer patients who have received surgery, in addition to postoperative chemoradiotherapy.
From May 1991 to December 2012, a total of 113 head and neck cancer patients who received surgery, along with postoperative chemoradiotherapy were analyzed. The primary sites were oral cavity (86), oropharynx (17), hypopharynx (4), and larynx (6). Thirty-nine patients received cisplatin (P), while 74 patients received cisplatin plus 5FU (PF). The endpoints were overall survival (OS), local failure-free survival (LFFS), and distant metastasis-free survival (DMFS).
The median follow up time was 43months, with a range of 4-222months. The 3-year rates of OS, LFFS, and DMFS were 62.1%, 71.3%, and 82.4%, respectively. The 3-year OS for P and PF were 71.3% and 57.5% (p=0.27). A multivariate analysis revealed that various chemotherapy regimens displayed no statistical difference for OS (Hazard Ratio [HR]=1.81; 95% Confidence Interval [CI]=0.963-3.408; p=0.065), LFFS (HR=0.98; 95% CI=0.458-2.127; p=0.973), and DMFS (HR=1.25; 95% CI=0.463-3.398; p=0.656). Grade 3 and 4 mucositis for P and PF group were 61.5% and 64.9%. A greater than grade 3 dermatitis for P and PF group were 7.7% and 14.9%.
Postoperative chemoradiotherapy with cisplatin alone appeared to have higher 3-year OS and lower severe mucositis and dermatitis than cisplatin plus 5FU.
比较顺铂单药化疗和顺铂联合5-氟尿嘧啶化疗在接受手术及术后放化疗的头颈癌患者中的治疗效果和毒性。
分析1991年5月至2012年12月期间共113例接受手术及术后放化疗的头颈癌患者。原发部位为口腔（86例）、口咽（17例）、下咽（4例）和喉（6例）。39例患者接受顺铂（P）治疗，74例患者接受顺铂联合5-氟尿嘧啶（PF）治疗。观察终点为总生存期（OS）、无局部复发生存期（LFFS）和无远处转移生存期（DMFS）。
中位随访时间为43个月，范围为4 - 222个月。3年OS、LFFS和DMFS率分别为62.1%、71.3%和82.4%。P组和PF组的3年OS分别为71.3%和57.5%（p = 0.27）。多因素分析显示，不同化疗方案在OS（风险比[HR]=1.81；95%置信区间[CI]=0.963 - 3.408；p = 0.065）、LFFS（HR = 0.98；95% CI = 0.458 - 2.127；p = 0.973）和DMFS（HR = 1.25；95% CI = 0.463 - 3.398；p = 0.656）方面无统计学差异。P组和PF组3/4级黏膜炎发生率分别为61.5%和64.9%。P组和PF组大于等于3级皮炎发生率分别为7.7%和14.9%。
与顺铂联合5-氟尿嘧啶相比，单纯顺铂术后放化疗的3年OS更高，严重黏膜炎和皮炎发生率更低。
