T-status and an oral fluoropyrimidine, S-1, adjuvant chemotherapy are prognostic factors in reduced-RADPLAT for resectable hypopharyngeal cancer
T-status and an oral fluoropyrimidine, S-1, adjuvant chemotherapy are prognostic factors in reduced-RADPLAT for resectable hypopharyngeal cancer
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DOI：
10.3109/00016489.2016.1157728
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发表时间：
2016-01-01
影响因子：
1.4
通讯作者：
Yoshizaki, Tomokazu
中科院分区：
文献类型：
--
作者：
Wakisaka, Naohiro;Hirai, Nobuyuki;Yoshizaki, Tomokazu
结论：与包括原始RADPLAT在内的同期放化疗相比，减量RADPLAT治疗HPC获得了相对的存活率和局部区域控制率，且毒性较低。S-1辅助化疗对患者的生存有促进作用。目的：评价靶向动脉灌注顺铂(IA)联合减量放射治疗(Reduced-RADPLAT)治疗可切除下咽癌(HPC)的疗效和毒副反应。方法：分析1999-2012年间接受Reduced-RADPLAT治疗的50例II-IVA期HPC患者的临床资料。采用IA顺铂(100 mg/体)静脉滴注2~5个疗程，在常规放射治疗(66~70Gy)的同时全身滴注硫代硫酸钠。2003年后，所有符合条件的患者均接受口服氟嘧啶类药物S-1辅助化疗。结果：中位随访期48.6个月，3年和5年总生存率(OS)、无进展生存率(PFS)、局部控制率和无喉食道功能障碍生存率(LEDFS)分别为76.0%和62.0%、58.0%和50.0%、66.0%和62.0%、56.0%和54.0%。3级毒副反应发生率为30.0%。没有患者出现4级或更高的毒性反应。治疗后3个月无1例患者需要管饲或气管切开。T4病变和S-1治疗分别是预测OS、PFS和LEDFS差和好的显著因素。
Conclusion: Reduced-RADPLAT for HPC achieved comparative survival and locoregional control rates with lower toxicities compared with concurrent chemoradiotherapies including original RADPLAT. S-1 adjuvant chemotherapy showed a survival benefit. Objectives: To evaluate the efficacy and toxicities of targeted intra-arterial (IA) infusion of cisplatin with concurrent radiotherapy with a reduced dose (reduced-RADPLAT) for resectable hypopharyngeal cancer (HPC). Methods: Between 1999-2012, 50 patients with stage II-IVA HPC primarily treated by reduced-RADPLAT were analyzed. They were treated by 2-5 courses of IA cisplatin infusion (100mg per body) with simultaneous systemic infusion of sodium thiosulfate concurrent with conventional radiotherapy (66-70Gy). After 2003, S-1, an oral fluoropyrimidine, adjuvant chemotherapy was administered to all eligible patients. Results: During a median follow-up of 48.6 months, the estimated 3- and 5-year overall survival (OS), progression-free survival (PFS), locoregional control, and laryngoesophageal dysfunction-free survival (LEDFS) rates were 76.0% and 62.0%, 58.0% and 50.0%, 66.0% and 62.0%, and 56.0% and 54.0%, respectively. Grade 3 toxicities were observed in 30.0%. No patient had grade 4 or higher toxicities. No patient required tube feeding or tracheotomy at 3 months after treatment. T4-lesions and S-1 administration were significant factors predicting poor and good OS, PFS, and LEDFS, respectively.