Adelstein D J, Sharan V M, Earle A S, Shah A C, Vlastou C, Haria C D, Carter S G, Damm C, Hines J D
Department of Medicine, Cleveland Metropolitan General Hospital, OH 44109.
NCI Monogr. 1988(6):347-51.
Fifty-four patients with previously untreated or minimally treated locally confined (MO) squamous cell carcinoma of the head and neck were treated with chemoradiotherapy employing multiple courses of simultaneous radiation, cisplatin, and a 4-day 5-fluorouracil infusion. Twenty-eight patients subsequently underwent definitive surgery, and 26 were treated without surgical resection. Of the 54 patients, 51 were ultimately rendered disease free by this combined modality protocol. The projected relapse-free survival rate for the entire cohort is 71%, with a median relapse-free survival time greater than 17 months. Thirteen patients who had tumors that were technically operable did not undergo surgery after achieving a complete response to induction chemoradiotherapy. Only 1 of these patients experienced subsequent local failure. Although the treatment-associated mucositis and local failure. Although the treatment-associated mucositis and myelosuppression were significant, this chemoradiotherapeutic protocol offers a significant chance of relapse-free survival for all patients with locally confined disease and merits comparison with more standard treatment approaches.
54例既往未治疗或仅接受过最低限度治疗的局部局限（M0）头颈部鳞状细胞癌患者接受了放化疗，采用多疗程同步放疗、顺铂以及为期4天的5-氟尿嘧啶输注。28例患者随后接受了根治性手术，26例未接受手术切除。在这54例患者中，51例最终通过这种联合治疗方案实现了无病状态。整个队列预计的无复发生存率为71%，无复发生存时间中位数超过17个月。13例肿瘤在技术上可切除的患者在诱导放化疗取得完全缓解后未接受手术。这些患者中只有1例随后出现局部复发。尽管治疗相关的粘膜炎和局部失败。尽管治疗相关的粘膜炎和骨髓抑制很严重，但这种放化疗方案为所有局部局限疾病患者提供了显著的无复发生存机会，值得与更标准的治疗方法进行比较。
