Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil.
Hospital Nossa Senhora da Conceição, Porto Alegre, Brazil.
Crit Rev Oncol Hematol. 2018 Nov;131:30-34. doi: 10.1016/j.critrevonc.2018.08.009. Epub 2018 Aug 27.
Squamous-cell carcinoma of the head and neck (SCCHN) is an important problem in Brazil, where epidemiological and socioeconomic features often create barriers to the implementation of combined modalities with curative potential. Cisplatin improves the efficacy of radiotherapy in the adjuvant treatment of localized SCCHN and in the definitive therapy of locally advanced disease. However, the addition of high-dose cisplatin to radiotherapy increases treatment toxicity and is not always warranted. A panel of experts convened in Sao Paulo, Brazil, for discussions and recommendations regarding the use of high-dose cisplatin in combination with radiotherapy in SCCHN. In addition to discussing their professional experience, panel members used the current literature to provide evidence-based, practical recommendations regarding sociodemographic or medical criteria that may preclude safe administration of cisplatin. It is hoped that the application of these recommendations in clinical practice may improve therapeutic results in Brazil and other countries with similar health-care environments.
头颈部鳞状细胞癌(SCCHN)是巴西的一个重要问题,其流行病学和社会经济特征常常给具有潜在治愈能力的联合治疗方法的实施带来障碍。顺铂可提高局部 SCCHN 辅助治疗和局部晚期疾病确定性治疗中放疗的疗效。然而,将高剂量顺铂添加到放疗中会增加治疗毒性,并不总是必要的。一个专家组在巴西圣保罗开会,讨论并提出关于高危顺铂联合放疗在 SCCHN 中的应用的建议。除了讨论他们的专业经验外,小组成员还利用当前的文献为可能阻碍顺铂安全使用的社会人口学或医学标准提供循证的实用建议。希望这些建议在临床实践中的应用可以改善巴西和其他具有类似医疗保健环境的国家的治疗结果。