Tannock I F
J Otolaryngol. 1984 Apr;13(2):99-104.
This overview of the role of chemotherapy in head and neck cancer is based on clinical trials conducted at The Princess Margaret Hospital and on a critical review of the literature. For recurrent or metastatic squamous cell carcinoma, no drug or combination has been found superior to methotrexate, which in large series gives transient responses in about 25% of patients. Reports of higher rates of response have not correlated with increased survival, and response rates from many series have been inflated by the use of poor and variable criteria of response or by inappropriate exclusion of patients. Chemotherapy may lead to high rates of response when used initially as part of combined modality treatment with radiation and/or surgery, but longterm benefit has not yet been demonstrated. Chemotherapy should not be considered part of standard management for recurrent or metastatic head and neck cancer, and should be used as part of primary treatment for loco-regional disease only in the context of large, well designed clinical trials.
本关于化疗在头颈癌中作用的概述基于在玛格丽特公主医院进行的临床试验以及对文献的批判性综述。对于复发或转移性鳞状细胞癌，未发现有任何药物或联合用药优于甲氨蝶呤，在大量病例系列中，甲氨蝶呤能使约25%的患者产生短暂缓解。更高缓解率的报道与生存率的提高并无关联，而且许多病例系列中的缓解率因使用了不佳且多变的缓解标准或不恰当排除患者而被夸大。当化疗最初作为放疗和/或手术联合治疗方式的一部分使用时，可能会导致较高的缓解率，但尚未证明其具有长期益处。化疗不应被视为复发或转移性头颈癌标准治疗的一部分，仅应在大型、设计良好的临床试验背景下作为局部区域疾病初始治疗的一部分使用。
