Rapid superselective high-dose cisplatin infusion with concomitant radiotherapy for advanced head and neck cancer
Rapid superselective high-dose cisplatin infusion with concomitant radiotherapy for advanced head and neck cancer
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DOI：
10.1002/hed.20116
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发表时间：
2005-01-01
影响因子：
2.9
通讯作者：
Fukuda, S
中科院分区：
文献类型：
--
作者：
Homma, A;Furuta, Y;Fukuda, S
目的.本研究的目的是评估快速超选择性大剂量顺铂输注联合放疗治疗既往未经治疗的晚期头颈部癌患者的疗效。方法. 43例禁忌手术或拒绝根治性手术的患者接受超选择动脉内输注顺铂（100-120 mg/m2/周），同时静脉输注硫代硫酸盐以中和顺铂毒性，并接受常规外照射放疗（65戈伊/26 f/6.5周）。结果39例患者为IV期疾病，其余4例为III期疾病。在中位随访21个月期间，所有患者（n = 43）和不可切除疾病患者（n = 24）的3年局部无进展率分别为68.9%和56.4%。此外，所有患者和不可切除疾病患者的3年总生存率分别为54.0%和39.6%。35例患者（81.4%）发生了III至IV级非血液学毒性，包括粘膜炎（n = 16）、恶心/呕吐（n = 8）和神经系统体征（n = 2）。无患者因治疗毒性而死亡。有29名存活的患者没有疾病的证据，他们都能够在没有饲管支持的情况下口服摄入。我们证实了超选择性动脉灌注和同步放射治疗的疗效，可以集中顺铂的局部区域疾病的攻击。即使是无法切除的疾病也可以治愈。需要进一步的研究来确定这种治疗的适应症，长期结果和可能的副作用。(C)2004 Wiley Periodicals，Inc.
Purpose. The purpose of this study was to evaluate the efficacy of rapid superselective high-dose cisplatin infusion with concomitant radiotherapy for previously untreated patients with advanced head and neck cancer. Methods. Forty-three patients for whom surgery was contraindicated or who rejected radical surgery were given superselective intra-arterial infusions of cisplatin (100-120 mg/m(2)/week) with simultaneous intravenous infusion of thiosulfate to neutralize cisplatin toxicity and conventional extra-beam radiotherapy (65 Gy/26 f/6.5 weeks). Results. Thirty-nine patients had stage IV disease, and the remaining four had stage III disease. During the median follow-up period of 21 months, the 3-year locoregional progression-free rates of all patients (n = 43) and patients with unresectable disease (n = 24) were 68.9% and 56.4%, respectively. In addition, the 3-year overall survival of all patients and patients with unresectable disease was 54.0% and 39.6%, respectively. Thirty-five patients (81.4%) experienced nonhematologic grade III to Iv toxicity, including mucositis (n = 16), nausea/vomiting (n = 8), and neurologic signs (n = 2). No patient died as a result of treatment toxicity. There are 29 surviving patients without evidence of disease, all of whom are able to have oral intakes without feeding-tube support.Conclusions. We confirmed the efficacy of superselectives arterial infusion and concomitant radiotherapy, which can concentrate the attack of supradosa cisplatin on locoregional disease. Even patients with unresectable disease can be cured. Further studies are needed to establish the indications, long-term outcome, and possible side effects of this treatment. (C) 2004 Wiley Periodicals, Inc.