Lee So Yeon, Choi Yoon Seok, Song Ik-Chan, Park Sang Gon, Keam Bhumsuk, Yang Young Jun, Song Eun-Kee, Lee Hyo Jin, Cho Sang-Hee, Shim Hyeok, Park Keon Uk, Lee Ki-Hyeong, Jo Deog-Yeon, Jo Ihn-Seong, Yun Hwan-Jung
Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon Department of Internal Medicine, Chosun University College of Medicine, Gwangju Department of Internal Medicine, Seoul National University College of Medicine, Seoul Department of Internal Medicine, Daejeon St. Mary's Hosptial, Catholic University of Korea College of Medicine, Daejeon Department of Internal Medicine, Chonbuk National University Medical School, Jeonju Department of Internal Medicine, Chonnam National University Medical School, Hwasoon Department of Internal Medicine, Wonkwang University School of Medicine, Iksan Department of Internal Medicine, Keimyung University College of Medicine, Daegu Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju Department of Internal Medicine, Eulji University College of Medicine, Daejeon, Republic of Korea.
Medicine (Baltimore). 2018 May;97(21):e10778. doi: 10.1097/MD.0000000000010778.
Standard treatment for locally advanced (stage III-IV) head and neck squamous cell cancer (LA-HNSCC) is concurrent chemoradiation therapy (CCRT) with cisplatin 100 mg/m every 3 weeks. For medically unfit patients susceptible to treatment-related adverse events, low-dose weekly cisplatin (30-40 mg/m) can be used as an alternative. In this study, we retrospectively compared the therapeutic outcomes of low-dose weekly cisplatin regimen and standard regimen in CCRT for LA-HNSCC.The medical records of histologically confirmed LA-HNSCC patients were retrospectively reviewed from January 1, 2007 to December 31, 2012. Patients who were treated with CCRT as initial treatment were included.Among 220 patients eligible, 65 (29.5%) were treated with cisplatin dosing schedule of 100 mg/m every 3 weeks and 155 (70.5%) with 30 to 40 mg/m weekly. The overall response rate in 3-weekly group was 92.3% and did not differ from that in weekly group (91.0%). The median progression-free survival of the weekly group was not attained but was not significantly different from that of 3-weekly group (50.7 months, 95% confidence interval [CI] 42.2-59.1 months) (P = .81). Also, the median overcall survival did not differ significantly between 2 groups (P = .34).In the present study, low-dose weekly cisplatin showed therapeutic outcomes comparable to standard-dose cisplatin in CCRT for LA-HNSCC. Prospective comparison of standard-dose three-weekly and low-dose weekly cisplatin is warranted.
局部晚期（III-IV期）头颈部鳞状细胞癌（LA-HNSCC）的标准治疗方案是每3周使用100mg/m顺铂进行同步放化疗（CCRT）。对于易发生治疗相关不良事件的身体状况不佳的患者，低剂量每周一次顺铂（30-40mg/m）可作为替代方案。在本研究中，我们回顾性比较了低剂量每周一次顺铂方案和标准方案在LA-HNSCC的CCRT中的治疗效果。对2007年1月1日至2012年12月31日经组织学确诊的LA-HNSCC患者的病历进行了回顾性分析。纳入以CCRT作为初始治疗的患者。在220例符合条件的患者中，65例（29.5%）接受每3周100mg/m顺铂给药方案治疗，155例（70.5%）接受每周30至40mg/m顺铂给药方案治疗。每3周一次给药组的总缓解率为92.3%，与每周一次给药组（91.0%）无差异。每周一次给药组的无进展生存期未达到中位数，但与每3周一次给药组无显著差异（50.7个月，95%置信区间[CI] 42.2-59.1个月）（P = 0.81）。此外，两组的总生存期中位数也无显著差异（P = 0.34）。在本研究中，低剂量每周一次顺铂在LA-HNSCC的CCRT中显示出与标准剂量顺铂相当的治疗效果。有必要对标准剂量每3周一次和顺铂低剂量每周一次进行前瞻性比较。
