Iop A, Cartei G, Vigevani E, Clocchiatti L, Mansutti M, Sibau A M
Division of Medical Oncology, Azienda Ospedaliera S. Maria della Misericordia, Udine, Italy.
Am J Clin Oncol. 1997 Oct;20(5):515-8. doi: 10.1097/00000421-199710000-00017.
The combination of cisplatin (CDDP 100 mg/m2 on day 1) and 5-fluorouracil (5-FU 1,000 mg/m2 continuous intravenous (i.v.) infusion days 1-5) is the most widely used chemotherapy regimen for the treatment of advanced head and neck carcinomas, with a response rate of 70-90% but with a survival and a duration of response which are not impressive. Most patients relapse in < or = 2 years and die of cancer. We evaluated the activity of a CDDP (90 mg/m2 on day 1), 5-FU (900 mg/m2/120 h continuous i.v. infusion from day 1), and mitomycin C (MMC 6 mg/m2 on day 1) regimen in advanced or recurrent head and neck squamous cell carcinoma (HNSCC). Fifty-six patients were treated and evaluated for response and toxicity: 5 (9%) complete responses (CR) and 36 (64%) partial responses, (PR) were observed (response rate 73%). The median duration of response was 12 months, and median survival was 15 months. At a median follow-up of 14 months, the estimated overall survival at 1 year was 65%; at 2 years, it was 35%. Grade 3-4 toxicity was noted in 14 patients, mostly hematologic; overall toxicity required a dose-intensity decrease in 20.2% of all cycles. No treatment-related deaths occurred. The regimen showed a good response rate and an encouraging median duration of response with a good tolerability profile.
顺铂（第1天100mg/m²）与5-氟尿嘧啶（第1 - 5天1000mg/m²持续静脉输注）联合是治疗晚期头颈癌最广泛使用的化疗方案，缓解率为70 - 90%，但生存率和缓解持续时间并不理想。大多数患者在≤2年内复发并死于癌症。我们评估了顺铂（第1天90mg/m²）、5-氟尿嘧啶（第1天起900mg/m²/120小时持续静脉输注）和丝裂霉素C（第1天6mg/m²）方案对晚期或复发性头颈部鳞状细胞癌（HNSCC）的疗效。56例患者接受治疗并评估疗效和毒性：观察到5例（9%）完全缓解（CR）和36例（64%）部分缓解（PR）（缓解率73%）。缓解的中位持续时间为12个月，中位生存期为15个月。中位随访14个月时，1年的估计总生存率为65%；2年时为35%。14例患者出现3 - 4级毒性，主要是血液学毒性；总体毒性导致20.2%的周期需要降低剂量强度。未发生与治疗相关的死亡。该方案显示出良好的缓解率、令人鼓舞的中位缓解持续时间以及良好的耐受性。
