博来霉素、环磷酰胺及放疗用于局部晚期头颈部表皮样癌的治疗

Bleomycin, cyclophosphamide and radiotherapy in regionally advanced epidermoid carcinoma of the head and neck.

作者信息

Seagren S L, Byfield J E, Davidson T M, Sharp T R

出版信息

Int J Radiat Oncol Biol Phys. 1982 Jan;8(1):127-32. doi: 10.1016/0360-3016(82)90397-2.

Abstract

We have treated 24 patients with squamous carcinoma of the head and neck and advanced regional (N2-3) disease. The regimen consisted of 3 cycles, each of 28 days. Cyclophosphamide (1 gm/m2 I.V.) was given on day 1, bleomycin (15 u I.M.) on days 2, 4, 9 and 11, and ionizing radiation (60Co, 180 rad/fraction) days 1-5, and 8-12. No therapy was given on days 13-28. After three cycles of therapy, 13 patients had a complete response; following further therapy (surgery, interstitial or external beam radiation), 16 patients were free of disease. However, remissions were not durable and 11/16 patients recurred loco-regionally with a median time to recurrence of 5 months; most (7/11 also developed distant metastases. These patients have biologically aggressive disease and may have a worse prognosis than patients who are Stage IV based on a T4 primary lesion only.

摘要

我们治疗了24例头颈部鳞状细胞癌且伴有晚期区域（N2-3）病变的患者。治疗方案包括3个周期，每个周期为28天。环磷酰胺（1克/平方米，静脉注射）在第1天给予，博来霉素（15单位，肌肉注射）在第2、4、9和11天给予，电离辐射（60钴，180拉德/分次）在第1至5天以及第8至12天进行。第13至28天不进行治疗。经过三个周期的治疗后，13例患者完全缓解；在进一步治疗（手术、间质或外照射放疗）后，16例患者无疾病状态。然而，缓解并不持久，16例患者中有11例局部区域复发，复发的中位时间为5个月；大多数（7/11）还发生了远处转移。这些患者患有生物学行为侵袭性的疾病，其预后可能比仅基于T4原发灶的IV期患者更差。