Department of Oncology, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
Department of Otolaryngology, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
Cancer Rep (Hoboken). 2022 Mar;5(3):e1479. doi: 10.1002/cnr2.1479. Epub 2021 Jun 28.
The standard chemotherapy treatment protocol for patients with recurrent/metastatic head and neck squamous cell carcinoma (HNSCC) requires as long as 56 days of hospitalization over six months. Where the 5-Fluorouracil (5-FU) pump is available, most treatment will be on outpatient bases, however patients will still be under chemotherapy treatment for a comparable period of time (around 50 days).
A modified protocol was assessed to decrease hospitalization and/or chemotherapy treatment time without sacrificing outcomes, to potentially increase patient quality of life.
A retrospective analysis (2005-2018) of recurrent/metastatic HNSCC patients with a modified treatment protocol was performed. Treatment consisted of cisplatin, cetuximab, 5-fluorouracil bolus and leucovorin administered on day 1 of a 2-week cycle, and a continuous infusion of 5-fluorouracil on days 1-2 of the cycle. Outcomes were measured by progression-free survival, overall survival, and patient hospitalization time. Analysis was done using the Kaplan-Meier survival function curve. The study cohort consisted of 27 patients. The modified treatment protocol resulted in a median progression-free survival of nine months and median overall survival of 14 months, while hospitalization time was reduced by almost 80% in the first six months of treatment.
Modification of the cisplatin, cetuximab, 5-FU and leucovorin protocol to a bi-weekly regimen utilizing alternative drug delivery methods, significantly reduced patient hospitalization from 56 days to 12 days in the first 6 months of treatment. This was achieved without compromising treatment outcome, while significantly reducing the days patients were exposed to chemotherapy, and thus potentially improving quality of life.
对于复发性/转移性头颈部鳞状细胞癌（HNSCC）患者，标准的化疗治疗方案需要长达 56 天的住院治疗，持续六个月。如果有 5-氟尿嘧啶（5-FU）泵可用，大多数治疗将在门诊进行，但患者仍将在可比的时间段内接受化疗治疗（约 50 天）。
评估一种改良方案，在不影响治疗效果的情况下减少住院和/或化疗治疗时间，以潜在提高患者的生活质量。
对采用改良治疗方案的复发性/转移性 HNSCC 患者进行了回顾性分析（2005-2018 年）。治疗方案包括顺铂、西妥昔单抗、氟尿嘧啶推注和亚叶酸钙，每两周周期的第 1 天给药，以及周期第 1-2 天的氟尿嘧啶持续输注。通过无进展生存期、总生存期和患者住院时间来衡量治疗效果。采用 Kaplan-Meier 生存函数曲线进行分析。研究队列包括 27 例患者。改良治疗方案使无进展生存期的中位数达到 9 个月，总生存期的中位数达到 14 个月，而治疗前 6 个月的住院时间减少了近 80%。
通过将顺铂、西妥昔单抗、氟尿嘧啶和亚叶酸钙方案修改为每两周一次的方案，并采用替代药物输送方法，显著减少了患者在治疗前 6 个月的住院时间，从 56 天减少到 12 天。这一目标是在不影响治疗效果的前提下实现的，同时显著减少了患者接受化疗的天数，从而潜在地提高了生活质量。
