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New development of superselective arterial infusion for head and neck cancer.

超选择性动脉输注治疗头颈癌的新进展。

基本信息

批准号：
18591854
负责人：
HOMMA Akihiro
金额：
$ 2.5万
依托单位：
Hokkaido University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2006
资助国家：
日本
起止时间：
2006 至 2007
项目状态：
已结题

项目摘要

Thirty-five patients with untreated and advanced head and neck cancer were given superselective intra-arterial infusions of cisplatin (100-120 mg/m^2/week) with simultaneous intravenous infusion of thiosulfate to neutralize cisplatin toxicity and conventional extra-beam radiotherapy (RADPLAT) between April 2006 and March 2008. Primary tumor sites included the nasal and paranasal sinuses (n=12), hypopharynx (n=8), oropharynx (n=6), larynx (n=6), oral cavity (n=2), parotidgland (n=1), and external auditory meatus (n=1).One hundred and eleven patients who were treated in or before 2006 were analyzed. During the median follow-up period of 27 months, the 5-year overall survival and local control of all patients were 69% and 88%, respectively. The local control rate of patients with less than T4b tumor was 91%, and those with T4b was 74%. However, the 5-year overall survival of patients T4b tumor was 49%. And the 5-year overall survival of patients T4b tumor was 49%. And the 5-year overall survival of patients with hypopharyngeal cancer was 49%. It was worse compared with other primary sites.We analyzed more in detail in hypopharyngeal cancer. Patients with T4b and/or N2c-3 had poor overall survival and local control. In addition, patients with hypopharyngeal cancer located in the midline had poor local control. In addition to clinicopathological factors, biological markers were analyzed to determine whether they were associated with a clinical outcome. Unfortunately, biological markers were not prognostic for overall survival and local control. RADPLAT eradicated cancer cells and showed excellent result. Therefore, it could overcome the low sensitivity to radiotherapy and chemotherapy of the cancer cells.Another reason may be the insufficient number of cases.Further studies are needed to establish the prognostic factors, the indications, and long-term outcome of this treatment.

自2006年4月至2008年3月，35例未经治疗的晚期头颈部癌症患者接受超选择性动脉内灌注顺铂(100-120 mg/m2/周)，同时静脉滴注硫代硫酸盐以中和顺铂毒性和常规射线外放射治疗(RADPLAT)。原发部位鼻腔鼻窦12例，下咽8例，口咽6例，喉6例，口腔2例，腮腺1例，外耳道1例。中位随访期27个月，5年总生存率为69%，局部控制率为88%。T4b以下肿瘤局部控制率为91%，T4b肿瘤局部控制率为74%。然而，T4b肿瘤患者的5年总生存率为49%。T4b肿瘤患者5年总生存率为49%。下咽癌患者的5年总生存率为49%。与其他原发部位相比，它更糟糕。我们更详细地分析了下咽癌。T4b和/或N2c-3患者总体生存率和局部控制率较低。此外，位于中线的下咽癌患者的局部控制性较差。除了临床病理因素外，还分析了生物标志物，以确定它们是否与临床结果有关。不幸的是，生物标志物并不能预测总体生存和局部控制。RADPLAT对癌细胞有很好的杀灭效果。因此，它可以克服癌细胞对放化疗的低敏感性。另一个原因可能是病例数量不足。这种治疗的预后因素、适应症和长期疗效有待进一步研究。