Induction chemotherapy in advanced squamous head and neck carcinoma with high‐dose cis‐platinum and bleomycin infusion
Induction chemotherapy in advanced squamous head and neck carcinoma with high‐dose cis‐platinum and bleomycin infusion
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大剂量顺铂联合博莱霉素输注诱导化疗治疗晚期鳞状头颈癌
作者：
Waun Ki Hong;Waun Ki Hong;S. Shapshay;R. Bhutani;Melody L. Craft;A. Ucmakli;Yamaguchi Kt;C. Vaughan;M. Strong
40例晚期头颈癌患者接受了顺铂-博来霉素联合化疗。第1天，在预水化后给予顺二氨二氯铂（DDP）120 mg/m2静脉给药，并使用甘露醇利尿。在第3天，通过快速静脉推注给予初始负荷剂量的博来霉素15 mg/m2，然后在第3天至第10天连续24小时静脉输注博来霉素15 mg/m2。第22天再次给予DDP 120 mg/m2 iv。在第29天至第35天之间评价患者的肿瘤缓解和可切除性。在39例可评价患者中，8例完全缓解或CR（20%），22例部分缓解或PR（56%），主要缓解率为76%。19例患者接受了手术（14例患者的病变最初不可手术，5例患者最初可手术）。40例患者化疗毒性反应包括脱发（40例）、呕吐（39例）、粘膜炎（11例）、皮疹（10例）、发热（17例）、体重减轻5磅以上。(25)、WBC小于3，000（2）、血小板小于100，000（1）、峰值血清肌酐2 mg%（3）、重度听力损失（1）、超敏反应（2）。手术并发症19例，咽瘘2例，切口裂开1例，脑膜炎、脑脓肿1例。有1例继发于肾毒性的死亡。这种特殊的联合化疗在作为初始治疗时，在减少肿瘤体积方面似乎非常有效。长期随访和随机化是必要的，以确定对生存的影响。
Forty patients with advanced head and neck cancer were treated with combined Cis‐platinum‐Bleomycin chemotherapy. Cis‐diammine dichloroplatinum (DDP) 120 mg/m2 iv was given after prehydration, with mannitol diuresis on Day 1. On Day 3, an initial loading dose of Bleomycin 15 mg/m2 was given by rapid iv push followed by continuous 24 hour intravenous infusion of Bleomycin 15 mg/m2 Day 3 through Day 10. DDP 120 mg/m2 iv was administered again on Day 22. The patients were evaluated for tumor response and resectability between Day 29 to Day 35. Of 39 patients who were evaluable, there were 8 complete responses or CR (20%) and 22 partial responses or PR (56%), for a major response rate of 76%. Nineteen patients had surgery (14 patients whose lesions were initially inoperable and 5 patients who were initially operable). Chemotherapy toxicity in 40 patients included alopecia (40), vomiting (39), mucositis (11), skin rash (10), fever (17), weight loss of more than 5 lbs. (25), WBC less than 3,000 (2), platelets less than 100,000 (1), peak serum creatinine of 2 mg% (3), severe‐hearing loss (1), hypersensitivity reaction (2). Surgical complication in 19 patients were pharyngocutaneous fistulae (2), wound dehiscence (1), meningitis and brain abscess (1). There was one death secondary to nephrotoxicity. This particular combination chemotherapy when given as initial treatment, appears very effective in reduction of tumor bulk. Long‐term follow‐up and randomization is necessary to determine effect upon survival.