IMPROVED COMPLETE RESPONSE RATE AND SURVIVAL IN ADVANCED HEAD AND NECK-CANCER AFTER 3-COURSE INDUCTION THERAPY WITH 120-HOUR 5-FU INFUSION AND CISPLATIN
IMPROVED COMPLETE RESPONSE RATE AND SURVIVAL IN ADVANCED HEAD AND NECK-CANCER AFTER 3-COURSE INDUCTION THERAPY WITH 120-HOUR 5-FU INFUSION AND CISPLATIN
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DOI：
10.1002/1097-0142(19850301)55:5
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发表时间：
1985-01-01
期刊：
影响因子：
6.2
通讯作者：
ALSARRAF, M
中科院分区：
文献类型：
--
作者：
ROONEY, M;KISH, J;ALSARRAF, M
1977-1981年间，在密歇根州底特律市的韦恩州立大学进行了一系列3项连续的初步研究，旨在测试既往未经治疗的晚期头颈部鳞状细胞癌患者的多模式治疗的可行性。患者接受了3种不同的诱导化疗方案：顺铂+长春新碱+博莱霉素（COB）2个疗程; 5-氟尿嘧啶（5-FU）96-h输注+顺铂2个疗程;或5-FU 120-h输注+顺铂3个疗程。3种诱导化疗方案的总体缓解率（完全缓解+部分缓解）均较高：分别为80%、88%和93%。5-FU输注120 h+顺铂3个疗程组的上级完全缓解率为54%，COB组为29%，5-FU输注96 h+顺铂2个疗程组为19%（P = 0.04）。在18个月时具有显著的生存优势。5-FU +顺铂诱导治疗3个疗程组的随访时间最短，实际T、N分期可能影响临床完全缓解率。无论后续手术和/或放疗如何，与无应答者相比，对初始化疗有应答者的生存率显著更好。这些研究表明，一个多模态的方法来管理先进的头颈部癌症是可行的。其中一个治疗组的上级完全缓解率和生存率表明，诱导化疗方案和/或疗程数的选择在这种多模式治疗方案中至关重要。
A series of 3 consecutive pilot studies were carried out between 1977-1981 at Wayne State University, Detroit, Michigan [USA], designed to test the feasibility of multimodality therapy in patients with previously untreated advanced squamous cell carcinoma of the head and neck. Patients received 3 different induction chemotherapy regimens: cisplatin + Oncovin (vincristine) + bleomycin (COB) for 2 courses; 96-h 5-fluorouracil (5-FU) infusion and cisplatin for 2 courses; or 120-h 5-FU infusion + cisplatin for 3 courses. Over-all response rates (complete response + partial response) to each of the 3 induction chemotherapy regimens were high: 80%, 88% and 93%, respectively. Superior complete response rate in the group receiving 3 courses of 120-h 5-FU infusion + cisplatin was 54% vs. 29% for COB and 19% for 2-course 96-h 5-FU infusion + cisplatin (P = 0.04). Significant survival advantage at 18 mo. minimum follow-up for the group receiving 3 courses of 120-h 5-FU + cisplatin induction therapy was found. Actual T and N stage may influence the clinical complete response rate. Responders to initial chemotherapy have significantly better survival as compared to nonresponders regardless of subsequent surgery and/or radiotherapy. These studies show that a multimodality approach to management of advanced head and neck cancer is feasible. Superior complete response rate and survival in 1 of the treatment groups suggest that choice of induction chemotherapy regimens and/or number of courses is of prime importance in such multimodality treatment programs.