Tsukuda M
Dept. of Otolaryngology, Yokohama City University, School of Medicine, Japan.
Gan To Kagaku Ryoho. 1998 Feb;25(3):303-8.
In head and neck carcinomas, over 50% of patients present with advanced local and regional disease. Despite curative treatments of radiotherapy and/or surgery for these advanced cases, locoregional control remains a significant problem with locoregional recurrences in up to 50-60% of cases. The prognosis of cases who relapse in the early period after their primary therapy, is poor, because of the poor response to chemotherapy and/or radiation therapy. Furthermore, metastatic recurrences in distant organs and second primaries are other medical problems. Chemotherapy is a key treatment in the management of locally recurrent patients during the early period after curative radiotherapy in primary therapy. Recently, chemotherapy including CDDP has been applied for locally recurrent patients. The response rate or chemotherapy, however, is low with a short duration time. The recent studies in terms of reirradiation for patients with locoregional recurrences were reviewed. Because of radiation therapy given in the primary therapy, reirradiation combined with chemotherapy (chemoradiation) has been used to improve the efficacy and to reduce the cumulative dose of reirradiation. Chemoradiation consisting of efficacious chemotherapy and a radiation dose of about 60 Gy is important to improve local control and survival of recurrent cases of head and neck carcinomas.
在头颈部癌中，超过50%的患者初诊时即表现为局部和区域晚期疾病。尽管对这些晚期病例采用了放疗和/或手术的根治性治疗，但局部区域控制仍然是一个重大问题，局部区域复发率高达50%-60%。在初次治疗后早期复发的病例预后较差，因为对化疗和/或放疗反应不佳。此外，远处器官的转移复发和第二原发肿瘤也是其他医学问题。化疗是原发性治疗中根治性放疗后早期局部复发患者管理的关键治疗方法。最近，包括顺铂在内的化疗已应用于局部复发患者。然而，化疗的缓解率较低，持续时间较短。本文综述了近期关于局部区域复发患者再程放疗的研究。由于在初次治疗中已进行过放疗，再程放疗联合化疗（放化疗）已被用于提高疗效并减少再程放疗的累积剂量。由有效的化疗和大约60 Gy的放射剂量组成的放化疗对于改善头颈部癌复发病例的局部控制和生存率很重要。
