Mead G M, Jacobs C
Am J Med. 1982 Oct;73(4):582-95. doi: 10.1016/0002-9343(82)90339-4.
The role of chemotherapy in the management of head and neck cancer includes treatment for recurrent disease and as an adjunct to conventional therapy with radiation and/or surgery in the primary treatment program. The best single agents, methotrexate and cisplatin, used for recurrent disease give response rates of 20 to 50 percent but of short duration. Results may be improved with combination chemotherapy, but often with increased toxicity. Prognostic factors that influence response are discussed. A newer role of chemotherapy in this disease is in the initial treatment program. Pretreatment chemotherapy can debulk these lesions prior to surgery and/or irradiation in up to 80 percent of patients. Controlled trials are in progress to determine the effect on cure rates. Chemotherapy utilized during radiotherapy has resulted in survival benefit in several studies. Post-treatment adjuvant chemotherapy still needs to be evaluated. The potential advantages and disadvantages of chemotherapy used in the initial treatment are discussed. Major strides have been made in the last decade in the treatment of head and neck cancer, and chemotherapy is assuming an increasingly important role.
化疗在头颈癌治疗中的作用包括治疗复发性疾病，以及在初始治疗方案中作为放疗和/或手术等传统疗法的辅助手段。用于复发性疾病的最佳单一药物甲氨蝶呤和顺铂，缓解率为20%至50%，但持续时间较短。联合化疗可能会改善疗效，但毒性往往会增加。文中讨论了影响疗效的预后因素。化疗在这种疾病中的一个新作用是在初始治疗方案中。预处理化疗可使高达80%的患者在手术和/或放疗前缩小这些病灶。目前正在进行对照试验以确定其对治愈率的影响。在多项研究中，放疗期间使用化疗已带来生存获益。治疗后辅助化疗仍有待评估。文中讨论了初始治疗中使用化疗的潜在优缺点。在过去十年中，头颈癌治疗取得了重大进展，化疗正发挥着越来越重要的作用。
