Therapeutic efficacy of selective intraarterial chemoradiotherapy with docetaxel and nedaplatin for human papilloma virus-negative oropharyngeal cancer
Therapeutic efficacy of selective intraarterial chemoradiotherapy with docetaxel and nedaplatin for human papilloma virus-negative oropharyngeal cancer
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DOI：
10.1016/j.anl.2021.10.014
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发表时间：
2022-04-15
影响因子：
1.7
通讯作者：
Murayama，Sadayuki
中科院分区：
文献类型：
--
作者：
Heianna，Joichi;Makino，Wataru;Murayama，Sadayuki
与人乳头瘤病毒阳性的口咽癌相比，人乳头瘤病毒阴性的口咽癌没有取得令人满意的结果。本研究评估了选择性动脉内放化疗与多西他赛和奈达铂方案的人乳头状瘤病毒阴性口咽cancer.MethodsTwenty-two连续人乳头状瘤病毒阴性口咽癌谁经历了选择性动脉内放化疗的治疗效果进行了回顾性分析。对原发肿瘤和全颈进行放射治疗（50戈伊）。随后，原发部位和转移淋巴结以20戈伊加强。动脉内化疗方案包括奈达铂（80 mg/m2）和多西他赛（60 mg/m2）的组合，最初在放疗开始时给药，每4周一次，共3次。根据靶动脉供应的肿瘤体积占总肿瘤体积的百分比确定抗癌剂的每个动脉内剂量，该百分比通过锥形束计算机断层扫描术中测量。结果指标为局部控制、无病生存率、总生存率和不良事件。使用Kaplan-Meier方法进行统计分析。ResultsThe中位随访期为59（范围，15 - 103）个月。T分期为T1/T2 5例（23%），T3 5例（23%），T4 12例（54%）。颈淋巴结转移≥ N2c者7例（32%）。所有患者在动脉内放化疗后首次影像学检查时均达到完全缓解。5年局部控制率、无病生存率和总生存率分别为96%（95%置信区间，0.72 - 0.99）、91%（95%置信区间，0.68 - 0.98）和100%（95%置信区间，不可用）。关于严重急性不良事件，分别在1例（5%）和11例（50%）患者中观察到4级喉水肿和白细胞减少。没有其他严重的急性不良事件observed.ConclusionSelective动脉内放化疗与多西他赛和奈达铂有可能实现有利的局部区域控制，无病生存率，总生存率在人乳头状瘤病毒阴性口咽癌。
ObjectiveHuman papilloma virus-negative oropharyngeal cancer has not achieved satisfactory outcomes compared with those of human papilloma virus-positive oropharyngeal cancer. This study evaluated the therapeutic efficacy of selective intraarterial chemoradiotherapy with the docetaxel and nedaplatin regimen for human papilloma virus-negative oropharyngeal cancer.MethodsTwenty-two consecutive patients with human papilloma virus-negative oropharyngeal cancer who had undergone selective intraarterial chemoradiotherapy were retrospectively analyzed. The primary tumor and whole neck were irradiated (50 Gy). Subsequently, the primary site and metastatic lymph nodes were boosted by 20 Gy. The intraarterial chemotherapy regimen comprised a combination of nedaplatin (80 mg/m2) and docetaxel (60 mg/m2), which was initially administered at the start of radiotherapy and was given every 4 weeks for three sessions. Each intraarterial dose of an anticancer agent was determined according to the percentage of the tumor volume supplied by the target artery to the total tumor volume, which was intraoperatively measured via cone-beam computed tomography. The outcome measures were locoregional control, disease-free survival, and overall survival rates and adverse events. Statistical analyses were performed using the Kaplan–Meier method.ResultsThe median follow-up period was 59 (range, 15–103) months. The T stage was T1/T2 in 5 patients (23%), T3 in 5 patients (23%), and T4 in 12 patients (54%). Cervical lymph node metastasis was staged as ≥N2c in 7 (32%) patients. Complete response was achieved in all patients at the first imaging examination after intraarterial chemoradiotherapy. The 5-year locoregional control, disease-free survival, and overall survival rates were 96% (95% confidence interval, 0.72–0.99), 91% (95% confidence interval, 0.68–0.98), and 100% (95% confidence interval, not available), respectively. Regarding serious acute adverse events, grade 4 laryngeal edema and leukopenia were observed in 1 (5%) and 11 patients (50%), respectively. No other serious acute adverse events were observed.ConclusionSelective intraarterial chemoradiotherapy with docetaxel and nedaplatin has the potential to achieve favorable locoregional control, disease-free survival, and overall survival rates in human papilloma virus-negative oropharyngeal cancer.