时辰诱导化疗序贯同步放化疗治疗局部晚期头颈部鳞癌的临床疗效观察

Clinical observation of induction chrono- chemotherapy followed by concurrent chemoradiation in patients with local advanced head and neck squamous cell carcinoma

目的:观察时辰诱导化疗序贯同步放化疗治疗局部晚期头颈部鳞癌的近期疗效、毒副反应。方法:对50例不可切除的局部晚期头颈部鳞癌先给予2-3周期TPF时辰诱导化疗,多西他赛75mg/m2,顺铂75mg/m2,分5天完成,静滴给药,每天10∶00-22∶00;5-氟尿嘧啶750mg/(m2·d),第1-5天,持续静滴,每天22∶00-10∶00,21天为1周期,然后调强放疗(IMRT),顺铂80mg/m2,3周重复同期化疗,治疗结束后评价疗效及毒副反应,并统计2年生存率。结果:50例均可评价疗效,其中CR 19例,PR 12例,SD 11例,PD 8例,总有效率(CR+PR)62.0%,疾病控制率(CR+PR+SD)84.0%。2年总生存率58.0%。结论:时辰诱导化疗后序贯同步放化疗治疗局部晚期头颈部鳞癌临床疗效较好,毒副反应可耐受。

Objective：To study the efficacy and toxicities of induction chrono-chemotherapy followed by concur-rent chemoradiation in local advanced head and neck squamous cell carcinoma. Methods：Fifty patients with unresect-ed locally advanced head and neck squamous cell carcinoma were treated with induction chrono-chemotherapy of two or three cycles regimen. The TPF chemotherapy regimen was administered as follows：TXT 75mg/m2;DDP 75mg/m2 , bolus infusion from 10：00 to 22：00,d1-5 ,and 5-FU 750mg/（ m2 ·d）bolus infusion from 22：00 to 10：00,d1-5 , with 21 days each cycle,followed by concomitant intensity - modulated radiotherapy（ IMRT ） and chemotherapy （DDP 80mg/m2,with 3 weeks each cycle）. The efficacy,toxicities and 2 years overall survival were reviewed after treatment. Results：All 50 patients were evaluated for response,CR 19 cases,PR 12 cases,SD 11 cases,PD 8 cases. The total efficiency was 62. 0%,the disease control rate was 84. 0% and 2 years overall survival rate was 58. 0%. Conclusion：Chrono-chemotherapy followed by concurrent chemoradiation is effective in the treatment of patients with locally advanced head and neck squamous cell carcinoma,and the toxicities are tolerable.