Studies on development of a new multidisciplinary treatment incorporating neo-adjuvant chemotherapy for head and neck cancer

头颈癌新辅助化疗联合多学科治疗的开发研究

• 批准号: 60570820
• 负责人: INUYAMA Yukio
• 金额: $ 1.09万
• 依托单位: Department of Otorhinolaryngology, School of Medicine, Keio University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for General Scientific Research (C)
• 财政年份: 1985
• 资助国家: 日本
• 起止时间: 1985 至 1986
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-60570820/
• 关键词: Neo-adjuvant chemotherapy; Pre-radiation chemotherapy; Combination chemotherapy with adriamycin analogs; CDDP and PEP

1. Fundamental research: (1)Combination chemotherapy of 4'-0-tetrahydropyranyladriamycin(THP),cisplatin(CDDP) and peplomycin(PEP) was studied using Ehrlich ascites carcinoma in ICR mice. As a result, it was concluded that sequential use of THP,CDDP and PEP was most effective. The mechanism of synergism was also studied using flow cytometry. (2)In order to test the advantage or usefulness of initial chemotherapy followed by radiotherapy(pre-radiation chemotherapy), the experimental study on combination of chemotherapy and radiotherapy was designed by using ICR mice and Ehrlich solid carcinoma. The results obtained were as follows: Synergistic effect of chemotherapy and radiotherapy was observed when chemotherapy was used prior to radiotherapy on Ehrlich solid carcinoma. On the other hand, even their additional effect was not recognized when radiotherapy preceded to chemotherapy on Ehrlich solid carcinoma. So the experimental results made it clear that pre-radiation chemotherapy is beneficial to to the treatment of the head and neck cancer.2. Clinical research: (1)We have started a new multidisciplinary treatment incorporating neo-adjuvant chemotherapy with CDDP and PEP since May 1981. The results of this treatment were evaluated. Five-year survival of all patients was 45%, which was relatively good considering that 80% of patients in this series were in stage III and IV. Five-year survival was significantly high in patients achieving CR with CDDP-PEP therapy (2)Clinical trial of combination chemotherapy with THP or adriamycin, CDDP and PEP was conducted for advanced head and neck cancer. Out of 25 patients, CR was achieved in 4 and PR in 11 with a response rate of 60%. So that, this combination was incorporated into neo-adjuvant chemotherapy.

1. 基础研究：(1)采用4′-0-四氢吡拉霉素（THP）、顺铂（CDDP）、培霉素（PEP）联合化疗，对ICR小鼠埃利希腹水癌进行研究。结果表明，依次使用THP、CDDP和PEP效果最好。用流式细胞术研究了协同作用的机制。(2)为了检验先化疗后放疗（放化疗前）的优势或有用性，以ICR小鼠和埃利希实体癌为研究对象，设计了放化疗联合的实验研究。研究结果如下：在放疗前先化疗治疗埃利希实体癌，观察到化疗与放疗的协同作用。另一方面，当放疗先于化疗治疗埃利希实体癌时，即使它们的额外效果也未被发现。因此，实验结果明确了放疗前化疗对头颈部肿瘤的治疗是有益的。临床研究：(1)从1981年5月开始，我们开始了一种新的多学科治疗，结合CDDP和PEP的新辅助化疗。对治疗结果进行了评价。所有患者的5年生存率均为45%，考虑到该系列中80%的患者处于III期和IV期，这是一个比较好的结果。CDDP-PEP治疗达到CR的患者5年生存率明显较高。(2)对晚期头颈癌进行THP或阿霉素、CDDP和PEP联合化疗的临床试验。在25例患者中，4例达到CR， 11例达到PR，有效率为60%。因此，这种组合被纳入新辅助化疗。

项目成果

犬山征夫,神崎仁,藤井正人,田中寿一,高岡哲郎,細田兵之助,他: 耳鼻と臨床. 33. 92-99 (1987)

Yukio Inuyama、Jin Kanzaki、Masato Fujii、Juichi Tanaka、Tetsuro Takaoka、Heinosuke Hosoda 等：耳鼻喉科和临床实践（1987 年）。

Yukio Inuyama: "Cancer of the ear - Results and new treatment policies -" Otologia Fukuoka. 33. 92-99 (1987)

犬山幸雄：“耳癌 - 结果和新的治疗政策 -”Otologia Fukuoka。

細田兵之助: 慶応医学. 63. 635-644 (1986)

细田 Hyanosuke：庆应义塾医学 63. 635-644 (1986)

犬山征夫: 治療. 69. 105-108 (1987)

犬山由纪夫：治疗。69. 105-108 (1987)

Inuyama,Y.: "Neoーadjuvant Chemotherapy" INSERM/John Libbey Eurotext, 12 (1986)

Inuyama, Y.：“新辅助化疗” INSERM/John Libbey Eurotext，12 (1986)