Tobias J S, Smith B J, Blackman G, Finn G
Department of Radiotherapy and Oncology, University College Hospital, London, U.K.
Radiother Oncol. 1987 Aug;9(4):263-8. doi: 10.1016/s0167-8140(87)80146-9.
In order to exploit the cytotoxic and radiosensitising actions of cis-platinum, we have treated 35 patients with locally advanced squamous cell carcinoma of the bronchus or head-and-neck. Each patient underwent radical irradiation (60 Gy/30 fractions over 6 weeks) with daily low-dose intravenous cisplatin (10 mg absolute dose per day) administered within 30 min of each daily radiation fraction. Total dose of cisplatin was 300 mg over 6 weeks. Although treatment was complicated by nausea in almost all patients and transient renal dysfunction in the majority, 27 patients completed treatment and renal function returned to normal or near normal in almost all cases. There was no obvious enhancement of pulmonary or skin toxicity, beyond what would have been expected from treatment with radical radiotherapy alone. There were two treatment-related deaths from renal failure. The response rate was high: all patients achieved at least a partial response, and in head-and-neck sites, there were nine complete responders and seven partial responders. Of the initial 35 patients, of whom all but two had advanced inoperable disease, 11 have died and 21 remain in continuous remission, 8-120 weeks from the start of treatment (median 55 weeks).
为了利用顺铂的细胞毒性和放射增敏作用，我们对35例局部晚期支气管或头颈部鳞状细胞癌患者进行了治疗。每位患者接受根治性放疗（6周内60 Gy/30次分割），同时在每次放疗分割的30分钟内每日静脉注射低剂量顺铂（绝对剂量每日10 mg）。顺铂的总剂量在6周内为300 mg。尽管几乎所有患者都出现了恶心，大多数患者出现了短暂的肾功能不全，使治疗变得复杂，但27例患者完成了治疗，几乎所有病例的肾功能都恢复到了正常或接近正常水平。除了单纯根治性放疗预期的毒性外，肺部或皮肤毒性没有明显增强。有2例因肾衰竭导致的与治疗相关的死亡。缓解率很高：所有患者至少达到部分缓解，在头颈部部位，有9例完全缓解者和7例部分缓解者。最初的35例患者中，除2例患者外均为无法手术的晚期疾病，11例患者死亡，21例患者仍处于持续缓解状态，从治疗开始起8 - 120周（中位时间55周）。
