Chemoradiation using low-dose cisplatin and 5-fluorouracil in locally advanced squamous cell carcinoma of the skin: A report of two cases
Chemoradiation using low-dose cisplatin and 5-fluorouracil in locally advanced squamous cell carcinoma of the skin: A report of two cases
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DOI：
10.1016/j.jaad.2005.12.035
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发表时间：
2006-11-01
影响因子：
13.8
通讯作者：
Otsuka, Fujio
中科院分区：
文献类型：
--
作者：
Fujisawa, Yasuhiro;Umebayashi, Yoshihiro;Otsuka, Fujio
最近，小剂量5-氟尿嘧啶/顺铂诱导联合放疗(放化疗)被报道对耳鼻喉科和妇科局部晚期鳞状细胞癌有效。然而，到目前为止，这种治疗方案还没有被评估为皮肤鳞状细胞癌。我们评估了两名局部晚期皮肤鳞状细胞癌患者使用顺铂和5-氟尿嘧啶的化疗放射治疗。顺铂和5-氟尿嘧啶的应用与常规分割放射治疗同时进行。顺铂(患者1：4 mg/m(2)/d，第1~5天；患者2：15 mg/m(2)/d，粘土1~5天)和5-氟尿嘧啶(患者1：400 mg/m(2)/d，连用7天；患者2：850 mg/m(2)/d，连用5天)分别静脉滴注1小时和24小时。患者1接受了两个疗程的化疗，间隔3周，患者2接受了一个疗程的化疗。两例患者的原发肿瘤均完全消退，留下溃疡。患者1的溃疡在3个月后完全消失。例2行手术切除、全厚皮片移植。组织病理学检查证实肿瘤完全消退。在这次治疗中，两名患者都没有出现严重的副作用。我们得出结论，使用顺铂和5-氟尿嘧啶的化疗放疗对这两名局部晚期皮肤鳞状细胞癌患者是有效的。多项随机研究表明，同步放化疗优于单纯放化疗。该方案是治疗不能切除的原发肿瘤或需要保留局部功能的患者的一种选择。
Recently, low-dose 5-fluorouracil/cisplatin induction concurrent with radiation (chemoradiation) has been reported to be effective for locally advanced squamous cell carcinoma of the otorhinolaryngologic and gynecologic regions. However, to date, this therapeutic option has not been evaluated for squamous cell carcinoma of the skin. We evaluated chemoradiation therapy using cisplatin and 5-fluorouracil in two patients with locally advanced squamous cell carcinoma of the skin. Administration of cisplatin and 5-fluorouracil was conducted concurrently with conventionally fractionated radiation therapy. Cisplatin (patient 1: 4 mg/m(2)/d on days 1 to 5; patient 2: 15 mg/m(2)/d on clays 1 to 5) and 5-fluorouracil (patient 1: 400 mg/m(2)/d for 7 days; patient 2: 850 mg/m(2)/d for 5 days) were administered intravenously for 1 hour and for 24 hours, respectively. Patient 1 underwent two courses of chemotherapy with a 3-week interval, and patient 2 underwent a single course of chemotherapy. The primary tumor of both patients showed complete regression, leaving ulceration. In patient 1, the ulceration completely resolved after 3 months. Patient 2 underwent surgical resection and full-thickness skin grafting. A histopathologic examination confirmed complete tumor regression. Neither patient suffered any serious side effects during this treatment. We conclude that chemoradiation using cisplatin and 5-fluorouracil was effective in these two patients with locally advanced squamous cell carcinoma of the skin. Several randomized studies have shown concurrent chemoradiation to be superior to radiation alone. This regimen is an option in managing patients who have unresectable primary tumors or who require preservation of local function.