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多西他赛联合化疗治疗晚期头颈部鳞状细胞癌的疗效与毒性

Efficacy and toxicity of docetaxel combination chemotherapy for advanced squamous cell cancer of the head and neck.

作者信息

Albers Andreas E, Grabow Regina, Qian Xu, Jumah Masen D, Hofmann Veit M, Krannich Alexander, Pecher Gabriele

机构信息

Department of Otorhinolaryngology-Head and Neck Surgery, Charité-Universitätsmedizin Berlin, CBF, D-12203 Berlin, Germany.

Medical Clinic of Hematology, Oncology and Tumor Immunology, Charité-Universitätsmedizin Berlin, CCM, D-10117 Berlin, Germany.

出版信息

Mol Clin Oncol. 2017 Jul;7(1):151-157. doi: 10.3892/mco.2017.1281. Epub 2017 Jun 1.

Abstract

The aim of the present study was to evaluate the clinical effectiveness and toxicity of docetaxel with 5-fluorouracil and cisplatin as combination treatment in patients with curable or metastatic/recurrent head and neck cancer by a retrospective cohort study of patients treated at a single institution between 2007 and 2012. Patients with locally advanced, metastatic and/or recurrent squamous cell carcinoma of the head and neck (SCCHN), who were treated with a combination therapy including docetaxel, were considered as eligible. Survival data, clinical side effects, quality of life (QoL) and toxicity profile were retrieved from patient charts, analyzed and scored according to the National Cancer Institute Common Toxicity Criteria, version 4, and the Response Evaluation Criteria In Solid Tumors, version 1.1. An overall response rate of 86% and a 3-year survival of 65.1% were observed. The median progression-free survival was 32 months. The cumulative incidence after 3 years was 16.9% for local recurrence and 10.4% for distant metastasis. Leukopenia (58%) and anemia (51%) were the most common hematological toxicities, followed by hepatotoxicity (53%) and nausea (27%). A total of 31% of the patients experienced a compromise in their QoL following therapy completion. In conclusion, docetaxel in combination with cisplatin and 5-fluorouracil was found to effectively prolong survival in patients with locally advanced and/or recurrent metastatic SCCHN. The overall survival, progression-free survival and response rates were in accordance with those reported by previous clinical trials. Therefore, this therapy protocol is recommended for patients with SCCHN in the curative as well as the palliative settings.

摘要

本研究的目的是通过对2007年至2012年在单一机构接受治疗的患者进行回顾性队列研究,评估多西他赛联合5-氟尿嘧啶和顺铂治疗可治愈或转移性/复发性头颈癌患者的临床疗效和毒性。局部晚期、转移性和/或复发性头颈部鳞状细胞癌(SCCHN)患者,若接受了包括多西他赛在内的联合治疗,则被视为符合条件。从患者病历中检索生存数据、临床副作用、生活质量(QoL)和毒性特征,并根据美国国立癌症研究所通用毒性标准第4版和实体瘤疗效评价标准第1.1版进行分析和评分。观察到总缓解率为86%,3年生存率为65.1%。中位无进展生存期为32个月。3年后局部复发的累积发生率为16.9%,远处转移的累积发生率为10.4%。白细胞减少(58%)和贫血(51%)是最常见的血液学毒性,其次是肝毒性(53%)和恶心(27%)。共有31%的患者在治疗结束后生活质量受到影响。总之,发现多西他赛联合顺铂和5-氟尿嘧啶可有效延长局部晚期和/或复发性转移性SCCHN患者的生存期。总生存期、无进展生存期和缓解率与先前临床试验报告的结果一致。因此,推荐该治疗方案用于SCCHN患者的根治性和姑息性治疗。

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