采用改良 TPEx 作为复发和/或转移性头颈部癌症的一线治疗方法。

Modified TPEx as First-line Treatment for Recurrent and/or Metastatic Head and Neck Cancer.

机构信息

Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Japan.

Department of Otorhinolaryngology-Head and Neck Surgery, Osaka Rosai Hospital, Sakai, Japan.

出版信息

Anticancer Res. 2021 Apr;41(4):2045-2051. doi: 10.21873/anticanres.14973.

DOI:10.21873/anticanres.14973

PMID:33813412

Abstract

BACKGROUND/AIM: To retrospectively evaluate the efficacy and safety of modified TPEx (docetaxel 60 mg/m on day 1, cisplatin 60 mg/m on day 1, and weekly cetuximab 250 mg/m with loading dose of 400 mg/m) followed by maintenance cetuximab as first-line treatment for inoperable recurrent and/or metastatic squamous cell carcinoma of the head and neck.

PATIENTS AND METHODS

We analyzed 22 Japanese patients receiving modified TPEx every 21 days for four cycles with or without prophylactic granulocyte colony-stimulating factor (G-CSF).

RESULTS

The best overall response rate was 55% [95% confidence interval (CI)=35-73]. The median progression-free survival and overall survival were 8.9 months (95%CI=3.9-10.2) and 14.3 months (95%CI=10.1-28.2), respectively. Without prophylactic G-CSF, Grade 3/4 neutropenia and febrile neutropenia was common (94% versus 20%; p=0.003 and 41% versus 0%; p=0.11, respectively).

CONCLUSION

The modified TPEx is effective, while prophylactic G-CSF is essential.

摘要

背景/目的：回顾性评估改良 TPEx（第 1 天给予多西他赛 60mg/m2，顺铂 60mg/m2，每周给予西妥昔单抗 250mg/m2，首剂给予 400mg/m2）联合维持治疗作为不可切除复发性和/或转移性头颈部鳞状细胞癌的一线治疗的疗效和安全性。

患者和方法

我们分析了 22 例日本患者，每 21 天接受改良 TPEx 治疗 4 个周期，有无预防性粒细胞集落刺激因子（G-CSF）治疗。

结果

最佳总体缓解率为 55%[95%置信区间（CI）=35-73]。中位无进展生存期和总生存期分别为 8.9 个月（95%CI=3.9-10.2）和 14.3 个月（95%CI=10.1-28.2）。无预防性 G-CSF 时，常见 3/4 级中性粒细胞减少和发热性中性粒细胞减少（94%比 20%；p=0.003 和 41%比 0%；p=0.11）。