Vokes E E, Brockstein B E, Humerickhouse R, Haraf D J
University of Chicago Department of Internal Medicine, Illinois, USA.
Oncology (Williston Park). 1998 Oct;12(10 Suppl 7):35-8.
The common clinical presentations of head and neck cancer include early (stage I or II) disease, locally or regionally advanced (stage III or IV, M0) disease, and recurrent or metastatic disease (< 5% of patients). Patients with stage I-II disease are usually cured following surgery or radiotherapy; those with more advanced disease, however, will benefit from chemotherapy--either as induction treatment to avoid surgery and preserve the larynx, or as simultaneous chemoradiotherapy for patients with locoregionally advanced disease; patients presenting with metastatic disease and those with recurrent disease receive chemotherapy as the primary treatment modality. The clinical experience with oral chemotherapy in head and neck cancer patients is limited, partly because of the anatomic location of the disease and complications of local treatment. At the University of Chicago, several regimens that include oral chemotherapy have been studied, including infusional 5-fluorouracil/oral hydroxyurea/radiotherapy, and eniluracil/oral 5-FU/radiotherapy. These trials and others assessing oral agents in the treatment of patients with head and neck cancer will be discussed.
头颈癌常见的临床表现包括早期（I期或II期）疾病、局部或区域晚期（III期或IV期，M0）疾病以及复发或转移性疾病（<5%的患者）。I-II期疾病患者通常在手术或放疗后治愈；然而，病情更严重的患者将从化疗中获益——化疗既可以作为诱导治疗以避免手术并保留喉部，也可以作为局部区域晚期疾病患者的同步放化疗；出现转移性疾病和复发性疾病的患者接受化疗作为主要治疗方式。头颈癌患者口服化疗的临床经验有限，部分原因是疾病的解剖位置和局部治疗的并发症。在芝加哥大学，已经研究了几种包含口服化疗的方案，包括静脉输注5-氟尿嘧啶/口服羟基脲/放疗，以及乙磺酰脲/口服5-氟尿嘧啶/放疗。将讨论这些试验以及其他评估口服药物治疗头颈癌患者的试验。
