Clinical outcomes of weekly cisplatin chemoradiotherapy for patients with pyriform sinus cancer.
Clinical outcomes of weekly cisplatin chemoradiotherapy for patients with pyriform sinus cancer.
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梨状窝癌患者每周顺铂化放疗的临床结果。
DOI：
10.1007/s10147-015-0821-8
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发表时间：
2015
期刊：
影响因子：
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通讯作者：
Fukuda S.
中科院分区：
文献类型：
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作者：
Sakashita T;Homma A;Hatakeyama H;Furusawa J;Kano S;Mizumachi T;Iizuka S;Onimaru R;Tsuchiya K;Yasuda K;Shirato H;Fukuda S.
背景梨状窝鳞状细胞癌（SCC）是上呼吸消化道恶性肿瘤中最严重的一种。下咽癌患者的临床疗效改善一直是特别具有挑战性的头部和颈部外科医生和oncologist.MethodsWe调查了30例梨状窝SCC，以验证每周顺铂化疗的有效性，同时放疗。顺铂在第1，2，3，5，6和7周的剂量为40 mg/m2，在确定性放疗的目的是保留喉。ResultsAll 30例患者实现了确定性放疗中位剂量为70戈伊（范围64-70戈伊）。顺铂伴随给药的中位数为5次（范围2-6次）。在4名患者（13%）中观察到原发性疾病持续或复发。5例患者（17%）出现持续或复发性淋巴结转移.对8名患者进行了9次挽救手术，其中7名患者存活，没有任何疾病证据。在2例患者（22%）中观察到术后并发症。5年总生存率和局部控制率分别为87%和96%。5年喉保存率为74%.ConclusionsThe方案的每周顺铂CRT可能是有效的梨状窝SCC，但是，有问题，在目前的研究中，由于大量的T2患者的强选择偏倚。挽救性手术是安全的，并能提高生存率。这种放化疗方案被认为是成功的保留喉功能。
BackgroundPyriform sinus squamous cell carcinoma (SCC) has one of the worst prognoses of all upper aerodigestive tract cancers. Improving clinical outcomes for patients with hypopharyngeal SCC has been particularly challenging for head and neck surgeons and oncologists.MethodsWe investigated 30 patients with pyriform sinus SCC to verify the effectiveness of weekly cisplatin chemotherapy with concurrent radiotherapy. Cisplatin was administered at a dose of 40 mg/m2on weeks 1, 2, 3, 5, 6, and 7 during definitive radiotherapy with the aim of preserving the larynx.ResultsAll 30 patients achieved definitive radiotherapy at a median dose of 70 Gy (range 64–70 Gy). Cisplatin was administrated concomitantly a median of five times (range 2–6 times). Persistent or recurrent primary disease was observed in four patients (13 %). Persistent or recurrent nodal metastasis was observed in five patients (17 %). Nine salvage surgeries were performed for eight patients, of whom seven survived without any evidence of disease. Post-operative complications were observed in two patients (22 %). The 5-year overall survival and locoregional control rates were 87 and 96 %, respectively. The 5-year laryngeal preservation rate was 74 %.ConclusionsThe regimen of weekly cisplatin CRT may be effective for pyriform sinus SCC; however, there were problems with strong selection bias in the current study due to the large number of T2 patients. Salvage surgery was safe and was able to improve the survival rate. This chemoradiation regimen was considered successful in preserving laryngeal function.