Hayashi Yuichiro, Mitsudo Kenji, Sakuma Kaname, Iida Masaki, Iwai Toshinori, Nakashima Hideyuki, Okamoto Yoshiyuki, Koizumi Toshiyuki, Oguri Senri, Hirota Makoto, Kioi Mitomu, Koike Izumi, Hata Masaharu, Tohnai Iwai
Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan.
Department of Radiology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan.
Radiat Oncol. 2017 Jul 3;12(1):112. doi: 10.1186/s13014-017-0847-3.
The aim of this retrospective observational study was to evaluate toxicities, overall survival, and locoregional control in elderly oral squamous cell carcinoma patients who had undergone retrograde intra-arterial chemotherapy combined with radiotherapy.
Thirty-one elderly patients over 80 years old with oral squamous cell carcinoma were enrolled in present study. The treatment schedule consisted of intra- arterial chemotherapy (docetaxel, total 60 mg/m; cisplatin, total 150 mg/m) and daily concurrent radiotherapy (total, 60 Gy) for 6 weeks.
The median patient age was 82.5 years old (range, 80-88 years). Of the 31 patients, six (19%) had stage II, 6 (19%) had stage III, 17 (55%) had stage IVA, and 2 (6%) had stage IVB. The median follow-up period for all patients was 37 months (range, 7-86 months). The 3-year overall survival and locoregional control rates were 78% and 81%, respectively. The major acute grade 3 adverse events were oral mucositis in 22 (71%) patients, neutropenia in 16 (52%), and dermatitis in 11 (35%). With respect to late toxicities, 1 patient (3%) developed grade 3 osteoradionecrosis of the jaw. No grade 4 or higher toxicities were observed during the treatment and follow-up periods.
Retrograde intra-arterial chemotherapy combined with radiotherapy was effective in improving overall survival and locoregional control even for elderly patients.
这项回顾性观察研究的目的是评估接受逆行动脉内化疗联合放疗的老年口腔鳞状细胞癌患者的毒性反应、总生存期和局部区域控制情况。
本研究纳入了31名80岁以上的老年口腔鳞状细胞癌患者。治疗方案包括动脉内化疗（多西他赛，总量60mg/m；顺铂，总量150mg/m）以及为期6周的每日同步放疗（总量60Gy）。
患者的中位年龄为82.5岁（范围80 - 88岁）。31名患者中，6例（19%）为II期，6例（19%）为III期，17例（55%）为IVA期，2例（6%）为IVB期。所有患者的中位随访期为37个月（范围7 - 86个月）。3年总生存率和局部区域控制率分别为78%和81%。主要的3级急性不良事件为22例（71%）患者出现口腔黏膜炎，16例（52%）出现中性粒细胞减少，11例（35%）出现皮炎。关于晚期毒性反应，1例（3%）患者发生3级颌骨放射性骨坏死。在治疗和随访期间未观察到4级或更高等级的毒性反应。
逆行动脉内化疗联合放疗即使对老年患者在提高总生存期和局部区域控制方面也是有效的。
