Chemotherapy following surgery for head and neck cancer. A Radiation Therapy Oncology Group Study.
Chemotherapy following surgery for head and neck cancer. A Radiation Therapy Oncology Group Study.
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头颈癌手术后的化疗。
DOI：
10.1097/00000421-198906000-00001
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发表时间：
1989
期刊：
影响因子：
--
通讯作者：
Laramore,GE
中科院分区：
文献类型：
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作者：
Jacobs,JR;Pajak,TF;al-Sarraf,M;Kinzie,J;Stetz,J;Davis,LW;Leibel,S;Laramore,GE
放射治疗肿瘤学组（RTOG）对可切除的局部晚期头颈癌患者进行了3个疗程的顺铂和120小时5-氟尿嘧啶（5-FU）输注化疗，随后进行标准放疗的可行性研究。79%的患者患有IV期癌症，65%的肿瘤为中度分化，原发部位为38%的口咽和28%的喉。化疗的毒性是可以接受的，没有危及生命的副作用。恶心和呕吐是最常见的副作用（78%），26%的患者为重度; 30%的患者发生白细胞减少症，22%发生贫血，13%发生血小板减少症，9%发生肾损害-所有这些都是轻度和可逆的。在6名患者中，由于医疗条件或由于患者拒绝而没有给予化疗。在23例术后开始顺铂和5-FU治疗的患者中，18例（78%）完成了所有三个疗程。96%的患者根据方案完成了充分的放疗。最少随访24个月，62%的患者存活。在过期患者中，5例死于其他原因，死亡时无复发证据。我们的结论是，顺铂化疗和5-FU输注后，明确的手术是可行的组的水平，和一个III期临床试验比较这种综合治疗的标准治疗手术和术后放疗正在进行的头颈部癌症国际组。
The feasibility of chemotherapy of three courses of cis-platin and 120-h 5-fluorouracil (5-FU) infusion after definitive surgery, followed by standard radiotherapy, in patients with resectable locally advanced head and neck cancer was carried out in Radiation Therapy Oncology Group (RTOG). Seventy-nine percent of the patients had stage IV cancer, 65% of the tumors were moderately differentiated, and primary sites were 38% oropharynx and 28% larynx. Toxicity to chemotherapy was acceptable, with no life-threatening side effects. Nausea and vomiting were the most common side effects (78%) and were severe in 26%; 30% of patients experienced had leukopenia, 22% had anemia, 13% had thrombocytopenia, and 9% had renal impairment—all of which were mild and reversible. In six patients, chemotherapy was not given for medical conditions or because of patient refusal. Of 23 patients started on cis-platin and 5-FU postsurgery, 18 (78%) completed all three courses. Ninety-six percent of the patients finished adequate radiotherapy according to the protocol. With minimum follow-up of 24 months, 62% of the patients were alive. Of the expired patients, 5 died from other causes, without evidence of recurrence at the time of their death. It is our conclusion that chemotherapy with cis-platin and 5-FU infusion following definitive surgery is feasible on the group level, and a Phase III trial comparing this combined modality therapy to standard treatment of surgery and postoperative radiotherapy is underway by the Head and Neck Cancer Intergroup.