联合应用紫杉特尔对头颈肿瘤诱导化疗的临床病例总结

Combined Usage of Taxotere in Induction Chemotherapy of Head and Neck Neoplasms

背景与目的:联合应用紫杉特尔对头颈肿瘤诱导化疗的报道不多,国外报道晚期头颈肿瘤应用TPF犤紫杉特尔(taxotere)+顺铂(cisplatin,DDP)+5-氟尿嘧啶(5-fluorouracil,5-FU)犦方案的总有效率可达93%。本研究旨在初步探讨TPF方案对头颈肿瘤诱导化疗的作用。方法:回顾1999年1月～2002年6月在我院应用TPF方案诱导化疗的头颈肿瘤25例。化疗具体实施如下:taxotere75mg/m2,静脉滴注,第1天;DDP20mg/m2,静脉滴注,第1～3天;5-FU300mg/m2,静脉滴注,第1～3天;每3周重复。治疗期间密切随访,观察不良反应,化疗结束后进行疗效评定。结果:TPF方案诱导化疗后原发灶呈完全缓解(CR)者6例(24.0%),部分缓解(PR)者12例(48.0%),微小反应或无反应者7例,总的有效率为72.0%。口腔癌的化疗有效率为63.6%(7/11),其它部位癌(包括舌根癌、喉癌、喉咽癌和鼻咽癌)的化疗有效率为71.4%(10/14),两者之间无显著性差异(P=0.504)。本组病例中有9例首次用其它方法治疗失败后出现原发灶复发或转移,应用TPF方案诱导化疗后临床CR者1例,PR者3例,总的化疗反应率为44.4%(4/9)。化疗后36.0%(9/25)的病例出现白细胞下降,按照WHO分度标准Ⅰ度16.0%(4/25),Ⅱ度16.0%(4/25),Ⅲ度4.0%(1/25);64%(16/25)患者化疗后出现胃肠道反应,按照WHO标准均为Ⅱ度以下;所有?

BACKGROUND &OBJECTIVE: There were few reports about combined usage of taxotere in induction chemotherapy of head and neck cancer. It was reported previously that the total response rate in advanced head and neck cancer using TPF regimen [taxotere+cisplatin(DDP)+5 fluorouracil (5 FU)] was 93%. In this article, the authors preliminarily reported the response rate and side effects of TPF regimen in head and neck cancers. METHODS: Twenty five cases with head and neck cancers in Guangzhou Tumor Hospital from January 1999 to June 2002 were reviewed. All cases underwent induction chemotherapy using TPF regimen (taxotere 75 mg/m2, iv drip, d1; DDP 20 mg/m2, iv drip, d1 3; 5 FU 300 mg/m2, iv drip, d1-3; repeat per 3 weeks). All cases were followed up during chemotherapy and their response was evaluated after induction chemotherapy. The side effects were recorded. RESULTS: Six cases (24.0%) and 12 cases(48.0%) presented complete remission (CR) and partial remission (PR) after induction chemotherapy using TPF regimen, respectively. There were 7 cases with minimal or none response. The total response rate (CR+PR) after TPF induction chemotherapy was 72.0%. The response rates in oral cancers and the cancers in other primary sites including the base of tongue, larynx, hypopharynx, and nasopharynx were compared. It demonstrated that the response rates were 63.6%(7/11) and 71.4%(10/14), respectively, and there was no significant difference between the two groups (P=0.504). In this study, there were 9 cases that relapsed after first treatment. Their response rate after TPF induction chemotherapy was 44.4%(4/9), which had 1 case of CR and 3 cases of PR. In this study, 36.0%(9/25) patients had leucopoenia including 16.0%(4/25) of degree Ⅰ, 16.0%(4/25) of degree Ⅱ, 4.0%(1/25) of degree Ⅲaccording to WHO standard;64%(16/25) of patients presented side effects in alimentary system, but the level was all under II according to WHO standard. The side effects in kidney in all patients were degree 0. Other side effects included hair loss but their degrees were all under Ⅱaccording to WHO standard. CONCLUSION: Induction chemotherapy using TPF regimen in local advanced head and neck cancers could have good chemotherapy response. It is effective for local relapse cases after first treatment and its side effects are tolerable.