Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA.
Division of Medical Oncology, Washington University School of Medicine, 660 South Euclid, Campus Box 8056, St. Louis, MO, 63110, USA.
Med Oncol. 2019 Oct 8;36(11):93. doi: 10.1007/s12032-019-1318-5.
In patients with locally advanced human papillomavirus (HPV)-unrelated head and neck squamous-cell carcinoma (HNSCC), cisplatin and radiation therapy (CisRT) resulted in a local-regional recurrence (LRR) rate of 35%, progression-free survival (PFS) of 49%, and overall survival (OS) of 60%. We, and others, showed that nab-paclitaxel is an active agent in metastatic and locally advanced HNSCC. The aim of this report was to assess the efficacy of nab-paclitaxel-based induction chemotherapy and CisRT in HPV-unrelated HNSCC. We performed a retrospective single-institution analysis of patients treated with nab-paclitaxel-based chemotherapy and CisRT. Key inclusion criteria included stage III-IV HPV-unrelated HNSCC. Induction chemotherapy included nab-paclitaxel and cisplatin (AP), AP + 5-fluorouracil (APF), or APF + Cetuximab (APF-C). Endpoints included LRR, overall relapse, PFS, and OS. Thirty-eight patients were the subject of this analysis. Patient characteristics included median age 59 years (IQR: 54-64) and smoking history in 36 patients (95%). Primary tumor sites included larynx/hypopharynx (27), p16 negative oropharynx (10), and oral cavity (1). Most patients had bulky disease: 82% T (n = 31) and 74% N (n = 28). Median follow-up was 44 months (IQR: 23-59). The three-year LRR rate was 16% (95% confidence interval [CI] 7-34) and the overall relapse rate was 22% (95% CI 11-41). The three-year PFS was 64% (95% CI 46-77) and OS was 72% (95% CI 54-84). Among patients with HPV-unrelated HNSCC, nab-paclitaxel-based induction chemotherapy and CisRT resulted in a lower-than-expected rate of LRR and more favorable PFS and OS compared to historical results with CisRT.
在局部晚期人乳头瘤病毒（HPV）相关头颈部鳞状细胞癌（HNSCC）患者中，顺铂和放疗（CisRT）导致局部区域复发（LRR）率为 35%，无进展生存期（PFS）为 49%，总生存期（OS）为 60%。我们和其他人表明，nab-紫杉醇在转移性和局部晚期 HNSCC 中是一种有效的药物。本报告的目的是评估 nab-紫杉醇为基础的诱导化疗联合 CisRT 在 HPV 无关的 HNSCC 中的疗效。我们对接受 nab-紫杉醇为基础的化疗和 CisRT 治疗的患者进行了回顾性单机构分析。关键纳入标准包括 III-IV 期 HPV 无关的 HNSCC。诱导化疗包括 nab-紫杉醇和顺铂（AP）、AP+5-氟尿嘧啶（APF）或 APF+Cetuximab（APF-C）。终点包括 LRR、总复发、PFS 和 OS。38 例患者为本次分析对象。患者特征包括中位年龄 59 岁（IQR：54-64）和 36 例（95%）有吸烟史。原发肿瘤部位包括喉/下咽（27 例）、p16 阴性口咽（10 例）和口腔（1 例）。大多数患者有大块疾病：82% T（n=31）和 74% N（n=28）。中位随访时间为 44 个月（IQR：23-59）。三年 LRR 率为 16%（95%CI：7-34），总复发率为 22%（95%CI：11-41）。三年 PFS 为 64%（95%CI：46-77），OS 为 72%（95%CI：54-84）。在 HPV 无关的 HNSCC 患者中，与 CisRT 相比，nab-紫杉醇为基础的诱导化疗联合 CisRT 导致 LRR 发生率较低，PFS 和 OS 更有利。
