晚期头颈癌的诱导化疗

Induction chemotherapy in advanced head and neck cancer.

作者信息

Tsukuda M, Mochimatsu I, Kokatsu T, Furukawa S, Yuyama S, Enomoto H, Kubota A

机构信息

Department of Otorhinolaryngology, Yokohama City University School of Medicine, Kanagawa, Japan.

出版信息

Auris Nasus Larynx. 1994;21(3):186-92. doi: 10.1016/s0385-8146(12)80143-x.

DOI:10.1016/s0385-8146(12)80143-x

PMID:7872896

Abstract

Induction chemotherapy, followed by definitive treatment, was performed in patients with advanced squamous-cell carcinoma of the head and neck. In this study, carried out between 1984 and 1991, testing the effectiveness of multimodality therapy in patients with previously untreated advanced (stage III and IV) squamous-cell carcinoma of the pharynx, patients received two different induction chemotherapy regimens: cisplatin, vincristine (Oncovin) plus peplomycin (COP), and cisplatin plus continuous 120-hr 5-fluorouracil (5-FU) infusion (CF) for two courses. Overall response rates (complete response plus partial response) to each of the two induction chemotherapy regimens were high: 76 and 82%, respectively. Superior complete response rate in the group receiving CF therapy was 16% versus 10% for COP therapy. Responders to induction chemotherapy had significantly better survival compared with non-responders. The toxicity of these two regimens was tolerable and manageable. It is indispensable to develop the more efficacious chemotherapy regimen with the potential to induce complete disappearance of tumors in patients with advanced head and neck carcinomas.

摘要

对于晚期头颈部鳞状细胞癌患者，先进行诱导化疗，然后进行确定性治疗。在1984年至1991年开展的这项研究中，为检测多模式疗法对先前未经治疗的晚期（III期和IV期）咽鳞状细胞癌患者的有效性，患者接受了两种不同的诱导化疗方案：顺铂、长春新碱（安可平）加培洛霉素（COP），以及顺铂加持续120小时5-氟尿嘧啶（5-FU）输注（CF），共两个疗程。两种诱导化疗方案各自的总缓解率（完全缓解加部分缓解）都很高：分别为76%和82%。接受CF疗法组的完全缓解率更高，为16%，而COP疗法组为10%。诱导化疗的应答者相比无应答者有显著更好的生存率。这两种方案的毒性是可耐受且可管控的。开发更有效的化疗方案对于晚期头颈部癌患者实现肿瘤完全消失至关重要。