SURVIVAL AND ANALYSIS OF FAILURE FOLLOWING HYDROXYUREA, 5-FLUOROURACIL AND CONCOMITANT RADIATION-THERAPY IN POOR PROGNOSIS HEAD AND NECK-CANCER
SURVIVAL AND ANALYSIS OF FAILURE FOLLOWING HYDROXYUREA, 5-FLUOROURACIL AND CONCOMITANT RADIATION-THERAPY IN POOR PROGNOSIS HEAD AND NECK-CANCER
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DOI：
10.1097/00000421-199110000-00012
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发表时间：
1991-10-01
影响因子：
2.6
通讯作者：
WEICHSELBAUM, RR
中科院分区：
文献类型：
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作者：
HARAF, DJ;VOKES, EE;WEICHSELBAUM, RR
39例头颈部肿瘤患者进入I-II期同步放射治疗，剂量为800 mg/m~2/d，持续滴注氟尿嘧啶，同时递增剂量羟基脲。其中20例患者在既往手术和/或放射治疗后复发(组1)。19例患者没有接受过局部治疗，但有晚期疾病(组2)。每隔一周重复一次周期，直到完成放射治疗。中位随访时间为32个月。复发的患者一般接受姑息性剂量的放射治疗(中位数剂量为5,000 cGy)，而以前未接受治疗的患者接受有治疗意图的放射治疗(中位数剂量为7,040 cGy)。15例可评估的复发患者的有效率为93%，40%的患者达到完全缓解。17例可评价的无复发患者，有效率为100%，完全有效率为71%。该方案在第1组患者中表现出高活性和显著的姑息疗效。然而，局部控制率为25%(5/20)，因为该组中的大多数患者最终发展为局部复发。第2组局部控制率为84%(16/19)。第1组患者局部失败率较高似乎与姑息剂量的放射治疗和较少的治疗周期有关。我们得出结论，该方案对先前局部治疗失败的患者有姑息性的好处，对预后较差的晚期疾病也有治愈的潜力。
Thirty-nine patients with head and neck cancer were entered into Phase I-II study of simultaneous radiation therapy with continuous infusion fluorouracil at 800 mg/m2/day and escalating doses of hydroxyurea. Twenty of these patients had recurrent disease after previous surgery and/or radiation therapy (group 1). Nineteen patients had not received prior local therapy but had advanced-stage disease (group 2). Cycles were repeated every other week until the completion of radiation therapy. The median follow-up was 32 months. Patients with recurrent disease were generally treated with palliative doses of radiation (median dose 5,000 cGy) while previously untreated patients received radiation with curative intent (median dose 7,040 cGy). The response rate for 15 evaluable patients with recurrent disease was 93% with 40% of patients achieving a complete response. For 17 evaluable patients without recurrent disease the response rate was 100%, with a complete response rate of 71%. This regimen exhibited a high activity and significant palliative benefit in group 1 patients. However the local control rate was 25% (5/20) because the majority of patients in this group eventually developed a local recurrence. The local control rate for group 2 patients was 84% (16/19). The higher local failure rate in group 1 patients appeared to be attributable to the palliative doses of radiation delivered and the fewer cycles of treatment received. We conclude that this regimen has palliative benefit in patients who have failed prior local therapy and has the potential for cure in patients with poor prognosis advanced stage disease as well.