Sakuma Kaname, Kii Tomoyuki, Machida Toko, Kikuchi Yosuke, Yoda Masaki, Toya Shuji, Tanaka Akira
Department of Oral and Maxillofacial Surgery, The Nippon Dental University School of Life Dentistry at Niigata, Niigata, Japan.
Oral and Maxillofacial Surgery, The Nippon Dental University in Niigata Hospital, Niigata, Japan.
Cancer Diagn Progn. 2024 Nov 3;4(6):769-774. doi: 10.21873/cdp.10394. eCollection 2024 Nov-Dec.
BACKGROUND/AIM: The therapeutic efficacy of the paclitaxel (PTX) + cetuximab (Cmab) combination regimen was investigated in patients with recurrence or metastasis after superselective intraarterial chemoradiotherapy (SSIACRT) for oral cancer, and the safety was retrospectively examined.
All enrolled patients with advanced oral cancer or who had refused surgery over 10 years from December 2012 to December 2022 underwent SSIACRT for 6 to 9 weeks [cisplatin (CDDP): total 160-630 mg/m and radiotherapy: total 50-70 Gy]. Nine cases (tongue cancer, maxillary gingival cancer, and mandibular gingival cancer; three cases each) were subjected to PTX + Cmab therapy. Recurrence or metastases were observed within six months after the onset of treatment, complicating the conduct of salvage surgery. Cmab (first dose: 400 mg/m and second and following doses: 250 mg/m) and PTX (80 mg/m) were administered weekly.
The overall response rate was 44.4% (four of nine cases), and the disease control rate was 88.9% (eight of nine cases), whereas the median progression-free survival was seven months, and the overall survival was 11 months. Grade 3-4 adverse events were neutropenia in 33.3% of the cases, leukopenia in 55.6%, anemia in 22.2%, and acneiform skin rash in 22.2%. Based on the above, PTX + Cmab therapy for recurrent and metastatic cases after SSIACRT had comparable results to other second-line modalities and enabled to cope with the side effects of myelosuppression.
PTX + Cmab therapy may be an effective treatment mode for recurrent or metastatic head and neck cancer resistant to CDDP after SSIACRT treatment.
背景/目的：研究紫杉醇（PTX）联合西妥昔单抗（Cmab）方案对口腔癌超选择性动脉内放化疗（SSIACRT）后复发或转移患者的治疗效果，并回顾性分析其安全性。
2012年12月至2022年12月期间，所有纳入的晚期口腔癌患者或拒绝手术超过10年的患者接受了6至9周的SSIACRT[顺铂（CDDP）：总量160 - 630mg/m²，放疗：总量50 - 70Gy]。9例患者（舌癌、上颌牙龈癌和下颌牙龈癌各3例）接受了PTX + Cmab治疗。治疗开始后6个月内观察到复发或转移，使得挽救性手术难以实施。每周给予Cmab（首剂：400mg/m²，第二剂及后续剂量：250mg/m²）和PTX（80mg/m²）。
总缓解率为44.4%（9例中的4例），疾病控制率为88.9%（9例中的8例），而无进展生存期的中位数为7个月，总生存期为11个月。3 - 4级不良事件包括33.3%的病例出现中性粒细胞减少、55.6%的病例出现白细胞减少、22.2%的病例出现贫血以及22.2%的病例出现痤疮样皮疹。基于以上情况，SSIACRT后复发和转移病例的PTX + Cmab治疗与其他二线治疗方式效果相当，且能够应对骨髓抑制的副作用。
PTX + Cmab治疗可能是SSIACRT治疗后对CDDP耐药的复发性或转移性头颈癌的一种有效治疗模式。
