Vokes E E, Moran W J, Awan A M, Schilsky R L, Goldman M, Sutton H G, Weichselbaum R R, Panje W R
Department of Medicine, University of Chicago, IL.
NCI Monogr. 1988(6):353-6.
Thirty-eight previously untreated patients with locally advanced head and neck cancer received three cycles of induction chemotherapy with methotrexate (120 mg/m2) followed by cisplatin (100 mg/m2) and a 5-day continuous infusion of 5-fluorouracil (1,000 mg/m2 per day). The response rate in 34 evaluable patients was 94%, with a complete response rate of 26%. Thirty-one patients underwent local therapy following induction chemotherapy, and 25 (81%) were rendered free of disease: 14 of 15 treated with surgery and radiotherapy and 11 of 16 treated with radiotherapy alone. At a median follow-up of 11 months, 8 patients have relapsed while the remaining 17 patients continue free of disease. The dose-limiting toxicity of chemotherapy was mucositis resulting in reduction of the 5-fluorouracil dose in 28 patients. This regimen is highly effective in inducing responses in patients with locally advanced head and neck cancer; 81% of the patients who complete local therapy are rendered free of disease with this multimodal approach. Due to short follow-up, the relapse rate, overall survival, and disease-free survival cannot yet be determined.
38例先前未接受过治疗的局部晚期头颈癌患者接受了三个周期的诱导化疗，化疗方案为甲氨蝶呤（120mg/m²），随后给予顺铂（100mg/m²）以及5天持续输注5-氟尿嘧啶（每日1000mg/m²）。34例可评估患者的缓解率为94%，完全缓解率为26%。31例患者在诱导化疗后接受了局部治疗，其中25例（81%）达到无病状态：15例接受手术和放疗的患者中有14例，16例仅接受放疗的患者中有11例。中位随访11个月时，8例患者复发，其余17例患者仍无疾病。化疗的剂量限制性毒性为粘膜炎，导致28例患者减少了5-氟尿嘧啶的剂量。该方案在诱导局部晚期头颈癌患者缓解方面非常有效；采用这种多模式方法，81%完成局部治疗的患者达到无病状态。由于随访时间短，复发率、总生存率和无病生存率尚无法确定。
