Saito Yuki, Ando Mizuo, Omura Go, Yasuhara Kazuo, Yoshida Masafumi, Takahashi Wataru, Yamasoba Tatsuya
Department of Otolaryngology and Head and Neck Surgery (y.s., m.a., g.o., k.y., m.y., t.y.).
Department of Radiology (w.t.) University of Tokyo Tokyo Japan.
Laryngoscope Investig Otolaryngol. 2016 Mar 29;1(2):28-32. doi: 10.1002/lio2.18. eCollection 2016 Apr.
OBJECTIVES/HYPOTHESIS: We aimed to determine the effectiveness of induction chemotherapy for treating p16-positive oropharyngeal cancer in our department.
This was a retrospective case series to assess treatment effectiveness.
We administered induction chemotherapy to patients with stage III to IV oropharyngeal p16-positive squamous cell carcinoma between 2008 and 2013. Induction chemotherapy was administered using combinations of docetaxel, cisplatin, and 5-fluorouracil. We measured the survival rates using the Kaplan-Meier method and log-rank test.
We reviewed 23 patients (18 men and 5 women; age, 42-79 years). Induction chemotherapy resulted in partial or complete remission (20 patients) and in stable (2 patients) or progressive (1 patient) disease. In partial or complete remission, subsequent radiotherapy was performed in 16 patients, chemoradiotherapy in two, and transoral resection in two. In stable or progressive disease, subsequent open surgery was performed. Overall, one patient died of cervical lymph node metastasis, one died of kidney cancer, and one died of myocardial infarction. Event-free, distant-metastasis-free survival was present for 20 patients. The 3-year disease-specific survival was 95%; the overall survival was 87%. Two patients required gastrostomies during chemoradiotherapy and three required tracheotomies, but these were closed in all patients.
The therapeutic response to induction chemotherapy for p16-positive oropharyngeal cancer was good. Partial or complete remission was achieved in almost 90% patients, and control of local and distant metastases was possible when it was followed by radiotherapy alone or with transoral resection of the primary tumor. A multicenter study is required to confirm these findings.
目的/假设：我们旨在确定在本科室诱导化疗治疗p16阳性口咽癌的有效性。
这是一项评估治疗效果的回顾性病例系列研究。
2008年至2013年期间，我们对III至IV期p16阳性口咽鳞状细胞癌患者进行诱导化疗。诱导化疗采用多西他赛、顺铂和5-氟尿嘧啶联合使用。我们使用Kaplan-Meier方法和对数秩检验测量生存率。
我们回顾了23例患者（18例男性和5例女性；年龄42 - 79岁）。诱导化疗导致部分或完全缓解（20例患者）以及病情稳定（2例患者）或进展（1例患者）。在部分或完全缓解的患者中，16例接受了后续放疗，2例接受了放化疗，2例接受了经口切除术。在病情稳定或进展的患者中，进行了后续开放性手术。总体而言，1例患者死于颈部淋巴结转移，1例死于肾癌，1例死于心肌梗死。20例患者无事件、无远处转移生存。3年疾病特异性生存率为95%；总生存率为87%。2例患者在放化疗期间需要胃造口术，3例需要气管切开术，但所有患者这些均已闭合。
p16阳性口咽癌对诱导化疗的治疗反应良好。近90%的患者实现了部分或完全缓解，并且在随后单独进行放疗或联合经口切除原发性肿瘤时，有可能控制局部和远处转移。需要进行多中心研究以证实这些发现。
4级。
