Fujii M, Ohno Y, Tokumaru Y, Imanishi Y, Kanke M
Dept. of Otolaryngology, Keio University School of Medicine.
Gan To Kagaku Ryoho. 1996 Nov;23(13):1740-6.
Combination chemotherapy with CDDP and 5-FU is one of the effective regimens for head and neck cancer. We studied the difference in the effects and adverse effects between two kinds of schedules of CDDP administration for CDDP-5-FU combination chemotherapy. For 13 patients, CDDP was administered on 5 consecutive days from day 1 to day 5 at a daily dose of 16 mg/m2 (Regimen A). For 14 patients CDDP was administered 80 mg on day 1 (Regimen B). 5-FU was administered 700 mg/m2/ day as a continuous drip infusion for 120 hours from day 1 to day 5. For regimen A, the response rate was 77%; for regimen B, it was 64%. The pattern of adverse effects showed a difference. Regimen B was more toxic for renal function than regimen A. But regimen A showed toxicity for bone marrow function. Acute phase nausea and vomit appeared more frequently in regimen B. The difference in the adverse effect pattern, which depends on the schedule of CDDP administration, seems important in order to apply this regimen for head and neck cancer patients safely. The schedule of CDDP administration should be changes depending on the renal and bone marrow function of patients. In order to evaluate the efficacy of UFT as adjuvant chemotherapy, UFT was administered p.o. to patients with maxillary sinus carcinoma for more than one year after definitive treatment with surgery or radiotherapy. Fifteen patients with UFT adjuvant chemotherapy showed significantly better survival rates than patients without adjuvant chemotherapy. We also studied adjuvant chemotherapy with CBDCA and FT for patients with advanced head and neck cancer. Administration with UFT (600 mg/day) from day 1 to day 14 with CBDCA 350 mg/m2 at day 7 was repeated more than twice. This regimen showed low toxicity and better survival for nasopharyngeal cancer patients. More clinical trials with this regimen for adjuvant chemotherapy are needed.
顺铂（CDDP）与氟尿嘧啶（5-FU）联合化疗是头颈部癌的有效治疗方案之一。我们研究了CDDP-5-FU联合化疗中两种CDDP给药方案在疗效和不良反应方面的差异。13例患者，从第1天至第5天连续5天给予CDDP，每日剂量为16mg/m²（方案A）。14例患者在第1天给予CDDP 80mg（方案B）。从第1天至第5天，5-FU以700mg/m²/天的剂量持续静脉滴注120小时。对于方案A，缓解率为77%；对于方案B，缓解率为64%。不良反应模式存在差异。方案B对肾功能的毒性比方案A更大。但方案A对骨髓功能有毒性。急性期恶心和呕吐在方案B中出现得更频繁。不良反应模式的差异取决于CDDP给药方案，这对于安全地将该方案应用于头颈部癌患者似乎很重要。CDDP给药方案应根据患者的肾功能和骨髓功能进行调整。为了评估优福定（UFT）作为辅助化疗的疗效，在手术或放疗的根治性治疗后，对上颌窦癌患者口服UFT超过一年。15例接受UFT辅助化疗的患者的生存率明显高于未接受辅助化疗的患者。我们还研究了卡铂（CBDCA）和替加氟（FT）对晚期头颈部癌患者的辅助化疗。从第1天至第14天给予UFT（600mg/天），并在第7天给予CBDCA 350mg/m²，重复两次以上。该方案对鼻咽癌患者显示出低毒性和更好的生存率。需要更多关于该方案辅助化疗的临床试验。
