Horiuchi M, Tamura Y, Miyake H
Dept. of Otolaryngology, Tokai University.
Gan To Kagaku Ryoho. 1994 Mar;21(4):417-24.
This review covers the clinical significance of neoadjuvant chemotherapy as initial treatment for squamous cell carcinoma of the head and neck, especially focusing on advanced but resectable disease. The rates of complete response (CR) after chemotherapy depended on the regimens and varied from 15% to 35%. Combined use with DDP/5-FU was considered as a most effective regimen. In addition of leucovorin to DDP/5-FU regimen, CR rate increased more than 50%. A randomized clinical trial has not shown any advantage for survival in advanced head and neck cancer. Recent reports have shown that distant metastases diminished in patients treated with neoadjuvant chemotherapy. When primary lesions disappeared completely after neoadjuvant chemotherapy, sequential use of radiotherapy can make the long term relapse-free in those lesions. This effort may lead to a modality of cancer treatment without surgery, so organ preservation will be possible.
本综述涵盖了新辅助化疗作为头颈部鳞状细胞癌初始治疗的临床意义，尤其关注晚期但可切除的疾病。化疗后的完全缓解（CR）率取决于治疗方案，在15%至35%之间变化。顺铂/5-氟尿嘧啶联合使用被认为是最有效的方案。在顺铂/5-氟尿嘧啶方案中加入亚叶酸钙，CR率提高超过50%。一项随机临床试验未显示新辅助化疗在晚期头颈癌生存方面有任何优势。最近的报告显示，接受新辅助化疗的患者远处转移减少。当新辅助化疗后原发灶完全消失时，序贯放疗可使这些病灶长期无复发。这种努力可能会导致一种无需手术的癌症治疗方式，从而实现器官保留。
