Amrein P C, Fingert H, Weitzman S A
J Clin Oncol. 1983 Jul;1(7):421-7. doi: 10.1200/JCO.1983.1.7.421.
Seventy patients with squamous cell carcinoma of the head and neck were treated with a 24-hour infusion of cisplatin, followed by vincristine and bleomycin. Among 37 patients with no prior treatment who had stage III (2) or stage IV (35) disease, there were 2 complete responders and 23 with a partial response, for an overall response frequency of 67%. Among 27 patients with recurrent disease after radiotherapy and/or surgery, there were 9 (33%) partial responses. Among 6 patients having failed prior chemotherapy, there was 1 complete responder, still in remission at 26 months. Response frequency was highly dependent on performance status and stage of disease, with a response of 80% in the 0 performance status group and 83% for stages less than T4N3M0. Among 18 patients with resectable disease, 51% remain disease-free at 12 months with an overall median survival at 16 months. Among the 33 patients with recurrent disease, the median duration of response and survival was 4 and 12 months for responders, respectively; nonresponders had a median survival of 5 months. The toxicity of this regimen was generally mild, with 21% of patients having no vomiting and 91% never having a serum creatinine over 2.0 mg/dL. There were 2 cases of pulmonary fibrosis. This chemotherapy regimen compares favorably with other published regimens for head and neck cancer with respect to activity and may be less toxic.
70例头颈部鳞状细胞癌患者接受了顺铂24小时输注治疗，随后使用长春新碱和博来霉素。在37例未经治疗的III期（2例）或IV期（35例）疾病患者中，有2例完全缓解，23例部分缓解，总缓解率为67%。在27例放疗和/或手术后复发的患者中，有9例（33%）部分缓解。在6例先前化疗失败的患者中，有1例完全缓解，在26个月时仍处于缓解状态。缓解率高度依赖于患者的体能状态和疾病分期，体能状态为0的患者缓解率为80%，疾病分期小于T4N3M0的患者缓解率为83%。在18例可切除疾病患者中，51%在12个月时无疾病生存，总体中位生存期为16个月。在33例复发疾病患者中，缓解者的中位缓解持续时间和生存期分别为4个月和12个月；未缓解者的中位生存期为5个月。该方案的毒性一般较轻，21%的患者未出现呕吐，91%的患者血清肌酐从未超过2.0mg/dL。有2例肺纤维化病例。就活性而言，该化疗方案与其他已发表的头颈部癌化疗方案相比具有优势，且毒性可能较小。
