Dasmahapatra K S, Citrin P, Hill G J, Yee R, Mohit-Tabatabai M A, Rush B F
J Clin Oncol. 1985 Nov;3(11):1486-9. doi: 10.1200/JCO.1985.3.11.1486.
Recent studies have shown improved efficacy of chemotherapy in patients with advanced squamous-cell cancer of the head and neck. Our purpose was to evaluate prospectively the activity of cisplatin plus 5-fluorouracil (5FU) in 37 patients with advanced stage IV squamous-cell cancer of the head and neck. There were two groups. Group 1 consisted of 19 previously untreated patients with either T4 or N3 disease. They received 100 mg/m2 cisplatin (days 1 and 28) and 120-hour infusion of 1,000 mg/m2/24 hours 5FU (days 1 to 5 and 28 to 32). They subsequently were offered preoperative radiotherapy (RT) and surgery. Group 2 consisted of 18 previously treated patients. They received 5FU and cisplatin in the same dosage every 28 days for either recurrent or metastatic disease. It was found that in group 1 there was an 84% response rate (five complete responses (CR) and 11 partial responses (PR) ). Three of those with PR achieved a CR after RT. Seven patients have had RT plus surgery and are disease free at 8 to 27 month follow-up. Six patients (one CR, five PR) refused surgery and progressed within 4 months. In group 2 there was an 11% response rate after two cycles (two PR), three patients had a minimal response (MR, less than 50% response) and received a mean of four cycles of treatment. Three patients with stable disease received a mean of four cycles of chemotherapy until progression. Two of 11 patients who had received previous chemotherapy plus RT showed an MR; nine of these patients had shown a response to their previous chemotherapy. Only one of 14 patients who had RT plus chemotherapy had a PR, and three had MR. Of five patients who had previous surgery, only one had a PR. All five had received chemotherapy as well. It was concluded that 5FU plus cisplatin is an effective combination in previously untreated patients. In previously treated patients with recurrent disease, there is a substantially lower response rate.
近期研究表明，晚期头颈部鳞状细胞癌患者接受化疗的疗效有所提高。我们的目的是前瞻性评估顺铂联合5-氟尿嘧啶（5FU）对37例晚期IV期头颈部鳞状细胞癌患者的治疗活性。研究分为两组。第1组由19例既往未接受过治疗的T4或N3期患者组成。他们接受100mg/m²顺铂（第1天和第28天）以及1000mg/m²/24小时的5FU持续120小时静脉输注（第1至5天和第28至32天）。随后他们接受术前放疗（RT）和手术。第2组由18例既往接受过治疗的患者组成。他们因复发或转移性疾病每28天接受相同剂量的5FU和顺铂治疗。结果发现，第1组的缓解率为84%（5例完全缓解（CR）和11例部分缓解（PR））。其中3例部分缓解患者在放疗后达到完全缓解。7例患者接受了放疗加手术，在8至27个月的随访中无疾病进展。6例患者（1例CR，5例PR）拒绝手术，在4个月内病情进展。第2组在两个周期后缓解率为11%（2例PR），3例患者有微小缓解（MR，缓解率小于50%），平均接受了4个周期的治疗。3例病情稳定的患者平均接受了4个周期的化疗直至病情进展。11例既往接受过化疗加放疗的患者中有2例出现微小缓解；这些患者中有9例对既往化疗有反应。14例接受过放疗加化疗的患者中只有1例部分缓解，3例微小缓解。5例既往接受过手术的患者中只有1例部分缓解。这5例患者也都接受过化疗。研究得出结论，5FU加顺铂对既往未接受过治疗的患者是一种有效的联合治疗方案。对于既往接受过治疗的复发患者，缓解率则显著较低。
