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每周紫杉醇、卡铂和西妥昔单抗作为诱导化疗或转移性或复发性头颈部癌的疗效和毒性,重点关注老年或体弱患者。

Efficacy and toxicity of weekly paclitaxel, carboplatin, and cetuximab as induction chemotherapy or in cases of metastases or relapse for head and neck cancer with a focus on elderly or frail patients.

机构信息

Department of Internal Medicine, Section of Medical Oncology, Yale New Haven Hospital, New Haven, Connecticut, USA.

出版信息

Head Neck. 2022 Aug;44(8):1777-1786. doi: 10.1002/hed.27077. Epub 2022 Apr 30.

Abstract

BACKGROUND

Paclitaxel, carboplatin, and cetuximab (PCC) has shown promise as induction chemotherapy and in patients with metastatic/recurrent head and neck cancer (HNC). Given its tolerability, the regimen is used in frail and elderly patients.

METHODS

Software generated the cohort of adult patients with HNC treated with PCC in 2014-2019. Modified RECIST response rate (RR), progression-free survival (PFS), and overall survival (OS) were calculated for the metastatic/recurrent group, and successful induction rate and RR for the induction group. These were also calculated in the elderly/frail subset (EF): age ≥75, performance status ≥2, albumin <3.5.

RESULTS

Fifty-two percent of patients experienced ≥grade 3 toxicities. For metastatic/recurrent disease (N = 58), RR was 22%, mean PFS was 7.1 months. Mean OS was 15.2 months. In the induction cohort (N = 22), 86% reached their endpoint. The RR was 64%. There were no significant differences for EF.

CONCLUSIONS

PCC is well-tolerated with good induction success rate and reasonable PFS/OS in metastatic/recurrent disease.

摘要

背景

紫杉醇、卡铂和西妥昔单抗(PCC)已被证明作为诱导化疗在转移性/复发性头颈部癌症(HNC)患者中有效。鉴于其耐受性,该方案用于体弱和老年患者。

方法

软件生成了 2014 年至 2019 年接受 PCC 治疗的 HNC 成年患者队列。计算了转移性/复发性组的改良 RECIST 缓解率(RR)、无进展生存期(PFS)和总生存期(OS),以及诱导组的诱导成功率和 RR。在老年/体弱亚组(EF)中也计算了这些指标:年龄≥75 岁,表现状态≥2 岁,白蛋白<3.5 岁。

结果

52%的患者出现≥3 级毒性。对于转移性/复发性疾病(N=58),RR 为 22%,平均 PFS 为 7.1 个月。平均 OS 为 15.2 个月。在诱导组(N=22)中,86%达到了终点。RR 为 64%。EF 组无显著差异。

结论

PCC 耐受性良好,转移性/复发性疾病的诱导成功率高,PFS/OS 合理。

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