Concurrent chemotherapy and radiotherapy for organ preservation in advanced laryngeal cancer
Concurrent chemotherapy and radiotherapy for organ preservation in advanced laryngeal cancer
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DOI：
10.1056/nejmoa031317
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发表时间：
2003-11-27
影响因子：
158.5
通讯作者：
Cooper, J
中科院分区：
文献类型：
--
作者：
Forastiere, AA;Goepfert, H;Cooper, J
背景：对于局部晚期喉癌患者，顺铂加氟尿嘧啶诱导化疗后放疗是全喉切除术的标准替代方案。放疗加化疗的价值和最佳化疗时机尚不清楚。方法：我们将局部晚期喉癌患者随机分为三组：诱导顺铂加氟尿嘧啶后放疗、放疗同时给予顺铂或单纯放疗。主要终点是保留喉。结果：547例患者被随机分配到三个研究组之一。中位随访期为3.8年。两年后，接受顺铂联合放疗的患者喉部完好率(88%)与先接受诱导化疗后再接受放疗(75%，P=0.005)或单纯放疗(70%，P<0.05)的患者相比，差异有统计学意义。
Background: Induction chemotherapy with cisplatin plus fluorouracil followed by radiotherapy is the standard alternative to total laryngectomy for patients with locally advanced laryngeal cancer. The value of adding chemotherapy to radiotherapy and the optimal timing of chemotherapy are unknown.Methods: We randomly assigned patients with locally advanced cancer of the larynx to one of three treatments: induction cisplatin plus fluorouracil followed by radiotherapy, radiotherapy with concurrent administration of cisplatin, or radiotherapy alone. The primary end point was preservation of the larynx.Results: A total of 547 patients were randomly assigned to one of the three study groups. The median follow-up period was 3.8 years. At two years, the proportion of patients who had an intact larynx after radiotherapy with concurrent cisplatin (88 percent) differed significantly from the proportions in the groups given induction chemotherapy followed by radiotherapy (75 percent, P=0.005) or radiotherapy alone (70 percent, P