Studies on concurrent radiotherapy and chemotherapy to point to preservation of the prgan and function for head and neck cancer

卡铂(CBDCA)联合放射治疗头颈部的试验始于1990年。结果，喉癌、口腔癌和副鼻窦癌的存活率较高。有趣的是，在保留喉的情况下，CBDCA加放疗组的总体存活率好于单纯放疗组。为此，从1995年开始在CBDCA+Rad组和CDDP+Rad组之间进行随机对照研究。96例患者随机分为两组，CBDCA组50例，CDDP组46例。完成78例，CBDCA组41/50例，顺铂组37/46例。完全性病例3年生存率CBDCA组为87.8%，CDDP组为61.5%。按原发部位计算，口咽部CBDCA组和CDDP组3年生存率分别为100%和64.3%，下咽CBDCA组和CDDP组分别为60.00%和83.3%，CBDCA组和CDDP组分别为94.1%和63.2%。CBDCA组与CDDP组比较差异无统计学意义。保留喉的3年生存率分别为：声门型86.7%vs顺铂55.6%，声门上型85.7%vs顺铂13.9%(P=0.0241)。T2期两组比较，差异有统计学意义，CBDGA为90%，CDDP为42.1%(P=0.0097)。在毒副反应方面，CBDCA组黏膜炎发生率和分级较低，骨髓抑制较严重，而CDDP组黏膜炎发生率和严重程度较高，骨髓抑制较低。

The trial of concurrent carboplatin (CBDCA) and radiotherapy for head and neck was initiated in 1990. As a result a better survival was achieved in cancers of the larynx, the oral cavity and the paranasal sinuses. Interestingly the overall survival with larynx preservation was better in the concurrent CBDCA and radio-therapy group than in radiation alone group. So the randomized controlled study has been conducted between CBDCA + Rad and CDDP + Rad group since 1995. The 96 patients were randomized into two groups : CBDCA group 50 cases vs CDDP group 46 cases. The 78 cases were completed ; CBDCA group : 41/50 and CDDP group : 37/46. The 3-year survivals of the complete cases were 87.8% in CBDCA group and 61.5% in CDDP group respectively. If we look at 3-year survival by primary site, CBDCA group : 100% and CDDP group : 64.3% in the oropharynx, CBDCA group : 60% and CDDP group : 83.3% in the hypopharynx, and CBDCA group : 94.1% and CDDP group : 63.2%, respectively. But there was no statistically significant difference between CBDCA group and CDDP group. Furthermore looking at the 3-year survival with larynx preservation, the results were as follows ; glottic : CBDCA : 86.7% vs CDDP : 55.6% (n.s.), supraglottic : CBDCA : 85.7% vs CDDP : 13.9% (p=0.0241). As for T2 cases, there was a significantly difference between the two groups ; CBDGA : 90% vs CDDP 42.1% (p=0.0097). In terms of toxicity, lower incidence and grade of mucositis, and severer bone marrow suppression were observed in CBDCA group, meanwhile higher incidence and grade of mucositis, and lower bone marrow suppression appeared in CDDP group.