Chemotherapy of squamous cell carcinoma of head and neck: the future is now.
Chemotherapy of squamous cell carcinoma of head and neck: the future is now.
复制标题
头颈鳞状细胞癌的化疗：未来就是现在。
作者：
E. Vokes;I. Athanasiadis
1996年，化疗在头颈癌中的作用已经确立。复发的患者将给予联合化疗。在这种情况下，研究新的药物或组合以及追求伴随的化学再照射是令人感兴趣的。对于局部进展性疾病的患者，诱导化疗可用于喉保存的目的。此外，化疗在鼻咽癌中的作用似乎正在以增加生存为治疗目标。顺铂和5-FU的联合不需要进一步的测试，然而，对生化调节的PF方案进行更明确的评估可能会引起人们的兴趣。此外，诱导化疗是一种理想的研究工具，可以进一步评估几种新药在头颈癌患者中的活性。最后，在一些随机临床研究中，联合放化疗已经导致了生存率的提高。鉴于不能切除的疾病患者的标准放疗预后较差，我们倾向于在这组患者中给予同步放化疗作为标准治疗。我们认为，在这组患者中单独使用放射治疗应限于表现不佳或其他高医疗风险的患者，这些患者不建议使用化疗。最后，鉴于治愈的头颈癌患者中第二恶性肿瘤和一般并发症的发生率很高，应向所有患者提供由肿瘤内科医生进行的化学预防研究和良好的预防性医疗护理。
In 1996, there is an established role for chemotherapy in head and neck cancer. Patients with recurrent disease will be offered combination chemotherapy. In this setting, investigations of new drugs or combinations and the pursuit of concomitant chemo-reirradiation are of interest. In patients with locoregionally advanced disease, induction chemotherapy can be used with the goal of larynx preservation. In addition, a role for chemotherapy in nasopharyngeal cancer appears to be emerging with increased survival as therapeutic goal. The combination of cisplatin and 5-FU does not need to be tested further, however, a more definitive evaluation of a biochemically modulated PF regimen might be of interest. Furthermore, induction chemotherapy represents an ideal investigational tool in which to further evaluate the activity of several new drugs in head and neck cancer patients. Finally, concomitant chemoradiotherapy has resulted in increased survival in several randomized clinical studies. Given the poor outcome of standard radiotherapy in patients with unresectable disease, we favor the administration of concomitant chemoradiotherapy in this group of patients as a standard therapy. In our opinion, the use of radiation therapy alone in this group of patients should be restricted to patients with poor performance status or other high medical risks that render the administration of chemotherapy unadvisable. Finally, given the high incidence of second malignancies and general medical complications in cured head and neck cancer patients, studies of chemoprevention and good preventive medical care by a medical oncologist should be made available to all patients.