SIMULTANEOUS CHEMORADIOTHERAPY AS SALVAGE TREATMENT IN LOCOREGIONAL RECURRENCES OF SQUAMOUS HEAD AND NECK-CANCER
SIMULTANEOUS CHEMORADIOTHERAPY AS SALVAGE TREATMENT IN LOCOREGIONAL RECURRENCES OF SQUAMOUS HEAD AND NECK-CANCER
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DOI：
10.1002/hed.2880150103
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发表时间：
1993-01-01
影响因子：
2.9
通讯作者：
CVITKOVIC, E
中科院分区：
文献类型：
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作者：
GANDIA, D;WIBAULT, P;CVITKOVIC, E
本研究的目的是确定是否可以获得长期的姑息治疗预照射局部复发鳞状头颈癌患者，同时放化疗的管理。强制性的合格标准是组织学记录的鳞状头颈癌在以前的照射领域，手术或近距离放射治疗挽救不可行，或患者拒绝。方案包括放疗，以2戈伊的5次/日的速率每隔一周进行，同时连续静脉输注800 mg/m2的5-氟尿嘧啶（5 FU）和口服1，000 - 1，500 mg/日的羟基脲（HU），持续5天。宽容是好的。急性毒性较低，未观察到超过或等于III级的WHO血液学毒性。9例患者出现III级粘膜炎，1例出现IV级粘膜炎，3例出现III级皮肤毒性，仅4例患者因此需要减少20%至30%的5 FU剂量，2例患者出现手足综合征，2例患者出现无症状的5 FU相关心脏体征（1例ECG，1例超声心动图+ ECG）。慢性放疗相关效应包括在2例患者中观察到的Hermitte征。在34例登记患者中，33例可评价缓解。总体目标[完全缓解（CR）+部分缓解（PR）]率为55%（18例患者），其中12例患者（36%）实现了疾病的局部控制。中位生存期为11年。这些数据表明，缓解可以获得大多数响应的患者，也表明这种类型的挽救程序的一组选定的复发性鳞状头颈癌患者的直接预后的改善。
This study was designed to determine if long-term palliation could be obtained in pre-irradiated locoregional recurrent squamous head and neck cancer patients, with the administration of simultaneous chemoradiotherapy. Mandatory eligibility criteria were histologically documented squamous head and neck cancer in previously irradiated territory, surgical or brachytherapy salvage unfeasibility, or patient refusal. The protocol consisted of radiotherapy, at a rate of 5 daily fractions of 2 Gy on alternate weeks, with simultaneous continuous intravenous infusion of 5-fluorouracil (5FU) at 800 mg/m2 and oral hydroxyurea (HU) at 1,000-1,500 mg/day for 5 days. Tolerance was good. Acute toxicity was low with no grade greater-than-or-equal-to III WHO hematologic toxicity observed. Nine patients had grade III mucositis, one had grade IV, three had grade III skin toxicity, and only four patients required a 20% to 30% 5FU dose reduction because of it. Two patients had hand and foot syndrome, and two had asymptomatic 5FU-related cardiac signs (1 ECG, 1 echographic + ECG). Chronic radiotherapy-related effects consisted of Hermitte's sign observed in two patients. Of 34 registered patients, 33 were evaluable for response. An overall rate of 55% (18 Patients) of objective [complete response (CR) + partial response (PR)] was obtained, with 12 patients (36%) achieving local control of disease. The median survival was 11 These data show that palliation could be obtained for the majority of responding patients, and also suggest an improvement in the immediate prognosis with this type of salvage procedure for a selected group of recurrent squamous head and neck cancer patients.