Kashyap Lakhan, Patil Vijay, Noronha Vanita, Joshi Amit, Menon Nandini, Jobanputra Kunal, Saha Saswata, Chaturvedi Pankaj, Banavali Shripad D, Prabhash Kumar
Department of Medical Oncology, Tata Memorial Hospital, Mumbai 400012, India.
Department of Head and Neck Oncosurgery, Tata Memorial Hospital, Mumbai 400012, India.
Ecancermedicalscience. 2021 Dec 2;15:1325. doi: 10.3332/ecancer.2021.1325. eCollection 2021.
A combination of maximum tolerated dose and metronomic chemotherapy schedule may lead to synergistic effects with acceptable toxicity. We assessed the efficacy and safety of this combination as neoadjuvant chemotherapy (NACT) in 14 patients with technically unresectable oral squamous cell carcinoma. They received NACT with paclitaxel-carboplatin and triple oral metronomic chemotherapy (OMCT) (methotrexate, celecoxib and erlotinib). Patients were assessed clinically and radiologically after a minimum of two cycles for resectability. Primary tumour site was buccal mucosa and oral tongue in 12 (86%) and 2 (14%) patients, respectively. The median number of NACT administered was three. The tumours of nine (65%) patients showed partial response and none of the patients had tumour progression. The tumours of nine patients (65%) were deemed resectable after NACT. Median progression free survival was 11.4 months (95% CI = 7.9-15 months) and median overall survival (OS) was not reached. OS at 15 months was 63.5% (95% CI = 37.8%-89.2%). Grade 3 or 4 haematological toxicities were seen in eight (57%) patients. Paclitaxel-carboplatin combined with OMCT is a well-tolerated and less resource intensive NACT regimen which leads to favourable resection rate and survival.
最大耐受剂量与节拍化疗方案相结合可能会产生协同效应，且毒性可接受。我们评估了这种联合方案作为新辅助化疗（NACT）在14例技术上无法切除的口腔鳞状细胞癌患者中的疗效和安全性。他们接受了紫杉醇-卡铂联合口服三联节拍化疗（OMCT）（甲氨蝶呤、塞来昔布和厄洛替尼）的NACT治疗。至少两个周期后，对患者进行临床和影像学评估以确定是否可切除。原发肿瘤部位分别为颊黏膜和舌，各有12例（86%）和2例（14%）患者。NACT的中位给药次数为三次。9例（65%）患者的肿瘤显示部分缓解，无患者出现肿瘤进展。9例（65%）患者的肿瘤在NACT后被认为可切除。中位无进展生存期为11.4个月（95%CI=7.9-15个月），中位总生存期（OS）未达到。15个月时的OS为63.5%（95%CI=37.8%-89.2%）。8例（57%）患者出现3级或4级血液学毒性。紫杉醇-卡铂联合OMCT是一种耐受性良好且资源消耗较少的NACT方案，可带来良好的切除率和生存率。
