Onaga Ryutaro, Enokida Tomohiro, Ito Kazue, Ueda Yuri, Okano Susumu, Fujisawa Takao, Wada Akihisa, Sato Masanobu, Tanaka Hideki, Takeshita Naohiro, Tanaka Nobukazu, Hoshi Yuta, Tahara Makoto
Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan.
Department of Head and Neck Oncology, Miyagi Cancer Center, Natori, Japan.
Front Oncol. 2023 Jun 15;13:1185198. doi: 10.3389/fonc.2023.1185198. eCollection 2023.
Despite advances in precision medicine, most patients with recurrent or metastatic salivary gland carcinoma still need conventional chemotherapies, such as the combination of taxane and platinum. However, evidence for these standardized regimens is limited.
We retrospectively reviewed patients with salivary gland carcinoma treated with a taxane and platinum, which contained docetaxel at a dose of 60 mg/m2 plus cisplatin at a dose of 70 mg/m2 on day 1, or paclitaxel at a dose of 100 mg/m2 plus carboplatin at a dose of area under the plasma concentration-time curve = 2.5 on days 1 and 8 (both on 21-day cycles), between January 2000 and September 2021.
Forty patients with ten adenoid cystic carcinomas and thirty other pathologies were identified. Of these, 29 patients were treated with docetaxel plus cisplatin and 11 with paclitaxel plus carboplatin. For the total population, the objective response rate (ORR) and median progression-free survival (mPFS) were 37.5% and 5.4 months (95% confidence interval: 3.6-7.4 months), respectively. On subgroup analysis, docetaxel plus cisplatin provided favorable efficacy compared with paclitaxel plus carboplatin (ORR: 46.5% 20.0%, mPFS: 7.2 2.8 months), and the findings were well retained in patients with adenoid cystic carcinoma (ORR: 60.0% 0%, mPFS: 17.7 2.8 months). Grade 3/4 neutropenia was relatively frequent in the docetaxel plus cisplatin (59% 27%), although febrile neutropenia was uncommon (3%) in the cohort. No treatment-related death was seen in any case.
The combination of taxane and platinum is generally effective and well-tolerated for recurrent or metastatic salivary gland carcinoma. In contrast, paclitaxel plus carboplatin appears unfavorable in terms of efficacy in certain patients, such as those with adenoid cystic carcinoma.
尽管精准医学取得了进展，但大多数复发性或转移性涎腺癌患者仍需要常规化疗，如紫杉烷与铂类的联合化疗。然而，这些标准化方案的证据有限。
我们回顾性分析了2000年1月至2021年9月期间接受紫杉烷与铂类联合化疗的涎腺癌患者，其中多西他赛剂量为60mg/m²加顺铂剂量为70mg/m²于第1天使用，或紫杉醇剂量为100mg/m²加卡铂剂量为血浆浓度-时间曲线下面积=2.5于第1天和第8天使用（均为21天周期）。
共纳入40例患者，其中10例为腺样囊性癌，其他病理类型30例。其中，29例患者接受多西他赛加顺铂治疗，11例接受紫杉醇加卡铂治疗。总体人群的客观缓解率（ORR）和中位无进展生存期（mPFS）分别为37.5%和5.4个月（95%置信区间：3.6 - 7.4个月）。亚组分析显示，与紫杉醇加卡铂相比，多西他赛加顺铂疗效更佳（ORR：46.5%对20.0%，mPFS：7.2对2.8个月），且在腺样囊性癌患者中结果相似（ORR：60.0%对0%，mPFS：17.7对2.8个月）。多西他赛加顺铂组3/4级中性粒细胞减少相对常见（59%对27%），尽管该队列中发热性中性粒细胞减少不常见（3%）。所有病例均未出现与治疗相关的死亡。
紫杉烷与铂类联合化疗对复发性或转移性涎腺癌总体有效且耐受性良好。相比之下，紫杉醇加卡铂在某些患者（如腺样囊性癌患者）中疗效似乎欠佳。
