紫杉醇联合顺铂治疗46例晚期头颈部肿瘤的临床观察

目的 观察紫杉醇联合顺铂治疗晚期头颈部肿瘤的疗效及毒副反应.方法 对46例晚期头颈部肿瘤进行化疗,方案为紫杉醇135 mg/m2,d1;顺铂25～40 mg/m2,d2～4.21 d为1周期,治疗2周期后评价疗效及毒副反应.结果 46例均可评价疗效,共完成周期数为160个,完全缓解(CR)2例,部分缓解(PR)14例,稳定(SD)18例,进展(PD)12例,总有效率(CR+PR)34.8%,疾病控制率(CR+PR+SD)73.9%,中位疾病进展时间6.7个月,中位生存期为22.3个月(2.0～52.5个月).主要毒副反应为骨髓抑制、胃肠道反应.结论 紫杉醇联合顺铂治疗晚期头颈部肿瘤疗效较好,毒副反应可耐受.     

卡铂或顺铂加氟尿嘧啶对头颈部鳞癌诱导化疗的疗效分析

局部中晚期头颈部鳞癌,以放射治疗为主,治疗失败的主要原因是局部复发和远处转移。放疗前诱导化疗使局部肿瘤缩小,减少乏氧细胞,有利于放疗;同时可以消灭临床病灶,减少远处转移［１］。我们对１９９５年—１９９７年５７例局部中晚期头颈部鳞癌患者,放疗前应用卡铂...     

长春瑞滨联合顺铂治疗晚期头颈部肿瘤的临床观察

目的:观察长春瑞滨联合顺铂(NP方案)治疗晚期头颈部肿瘤的临床疗效和毒副反应。方法:58例晚期头颈部肿瘤患者,接受NP方案化疗。长春瑞滨(NVB)25mg/m2,快速静滴,第1、8天给药;顺铂(DDP)30mg/m2,静滴,第1～3天给药,21天为1周期。化疗2周期以上,然后按WHO标准评价临床疗效和毒副反应。结果:58例患者均可评价疗效,获得CR7例,PR21例,SD16例,PD14例,有效率为48.3%,中位肿瘤进展时间(TTP)为8.5个月。主要毒副反应为骨髓抑制、恶心呕吐和脱发。结论:长春瑞滨联合顺铂治疗晚期头颈部肿瘤的临床疗效较高,毒副反应轻,值得进一步研究。     

低剂量5-氟脲嘧啶顺铂联合治疗头颈部肿瘤临床观察

目的观察低剂量5-氟脲嘧啶(5-FU)持续静脉滴注联合小剂量顺铂(DDP)治疗晚期头颈部肿瘤的疗效、毒副反应及临床受益改善情况.方法5-FU 300 mg/d持续24小时静脉输注;DDP采用5 mg/d连用5天间隔2天;两药持续应用12～17天,28天为1周期,至少连用2周期后评价疗效及毒副反应.结果全组20例,CR 0例,PR 7例,有效率(CR+PR)35%,临床受益改善12例(60%).主要毒副反应为外周静脉炎.结论低剂量FP方案是一个治疗晚期头颈部肿瘤有效低毒化疗方案.     

低剂量5-氟脲嘧啶顺铂联合治疗头颈部肿瘤

目的:观察低剂量5-氟脲嘧啶(5-FU)持续静脉滴注联合小剂量顺铂(DDP)治疗晚期头颈部肿瘤的疗效、毒副反应及临床受益改善情况。方法:5-FU 300 mg/d持续24小时静脉输注;DDP采用5 mg/d连用5天间隔2天;两药持续应用 12～17天,28天为 1周期,至少连用 2周期后评价疗效及毒副反应。结果:全组 20例,CR 0例,PR 7例,有效率(CR+PR)35％,临床受益改善12例(60％)。主要毒副反应为外周静脉炎。结论:低剂量FP方案是一个治疗晚期头颈部肿瘤有效低毒化疗方案。     

顺铂联合化疗方案治疗57例晚期肺癌疗效观察

顺铂联合化疗方案治疗５７例晚期肺癌疗效观察朱培森浙江省海宁市第二医院（３１４４００）迄今为止，晚期肺癌的化疗效果仍不满意。为探求较为理想的化疗方案，我科自１９９２年１月至１９９４年１２月应用顺铂联合化疗方案治疗晚期肺癌，取得较好疗效。现就可评定疗效、...     

吉西他滨联合顺铂治疗头颈部癌52例分析

目的 评价吉西他滨联合顺铂治疗复发转移性头颈部癌患者的疗效和毒性。方法 52例复发转移性头颈部癌患者接受吉西他滨联合顺铂方案：吉西他滨1000mg／m^2,第1天和第8天;顺铂25mg／m^2,第1～3天;21d为1个疗程。结果 可评价患者52例,3例（5．8％）达完全缓解,19例（36．5％）达部分缓解,有效率42．3％（22／52）。中位疾病进展时间5．0个月,中位生存期9．9个月,1年生存率为43．4％。在既往经含铂方案化疗的32例患者中,2例（6．3％）达完全缓解,11例（34．4％）达部分缓解,有效率为40．6％（13／32）。中位疾病进展时间3．4个月,中位生存期8．3个月,1年生存率为29．2％。主要不良反应为1或2度血液学毒性、皮疹和恶心呕吐。结论 吉西他滨联合顺铂是治疗晚期复发转移性头颈部癌患者安全、有效的联合化疗方案．     

以顺铂或卡铂为主联合化疗治疗晚期肺癌疗效分析

以顺铂或卡铂为主联合化疗治疗晚期肺癌疗效分析郭兰芝，高明芝为了提高晚期肺癌患者的生活质量，减少痛苦，延长生存期，我们采用以顺铂（ＤＤＰ）或卡铂（ＣＢＰ）为主联合其它抗肿瘤药物，治疗晚期肺癌５５例，疗效满意，现报告如下。临床资料一、病例选择５５例晚期肺...     

持续静脉滴注氟尿嘧啶联合顺铂治疗晚期头颈部癌

背景与目的:顺铂与氟尿嘧啶是治疗晚期头颈部肿瘤疗效确切的药物,但有一定的毒性反应。本研究观察持续静脉滴注氟尿嘧啶联合顺铂治疗晚期头颈部癌的疗效及安全性。方法:22例晚期头颈部癌患者给予氟尿嘧啶750mg/(m2.d)持续静脉滴注5d(120h),顺铂25mg/(m2.d),d1～3。21d为一个周期,2个周期后评价疗效。结果:CR1例(4.5%),PR8例(36.4%),近期客观有效率为40.9%(9/22)。中位TTP7.4个月,1年生存率为72.7%。初治与复治有效率分别为75.0%(6/8),21.4%(3/14),统计学差异有显著性(χ2=6.04,P<0.05)。主要毒副反应为骨髓抑制、胃肠道反应和粘膜炎。结论:持续静脉滴注氟尿嘧啶联合顺铂治疗晚期头颈部癌具有较好的疗效,安全性好。     

Efficacy of Aprepitant for Nausea in Patients with Head and Neck Cancer Receiving Daily Cisplatin Therapy

Background: Although efficacy of aprepitant for suppressing emesis associated with single-dose cisplatin hasbeen demonstrated, there are limited data on the antiemetic effect of this oral neurokinin-1 receptor antagonistduring daily administration of cisplatin. Accordingly, we investigated the efficacy and safety of aprepitant inpatients with head and neck cancer (HNC) receiving combination therapy with cisplatin and 5-FU (FP therapy).Materials and Methods: Twenty patients with HNC were prospectively studied who received a triple antiemeticregimen comprising granisetron (40μg/kg on Days 1-4), dexamethasone (8 mg on Days 1-4), and aprepitant (125mg on day 1 and 80mg on days 2-5) with FP therapy (cisplatin 20 mg/m2 on days 1-4; 5-FU 400 mg/m2 on days1-5) (aprepitant group). We also retrospectively studied another 20 HNC patients who received the same regimenexcept for aprepitant (control group). Results: For efficacy endpoints based on nausea, the aprepitant groupshowed significantly better results, including a higher rate of complete response (no vomiting and no salvagetherapy) for the acute phase (p=0.0342), although there was no marked difference between the two groups withregard to percentage of patients in whom vomiting was suppressed. There were no clinically relevant adversereactions to aprepitant. Conclusions: This study suggested that a triple antiemetic regimen containing aprepitantis safe and effective for HNC patients receiving daily cisplatin therapy.     

Effect of Palliative Drug Therapy on Quality of life in Advanced Head and Neck Cancer Patients

Advanced cancer patients are managed by palliative care and its main aim is to provide best possible quality of life to the patients by symptom management. Pain is the most agonizing symptom experienced by advanced head and neck cancer patients. Control of pain hence requires more attention by the caregiver in order to improve their quality of life. Recently quality of life issues have emerged as a main focus of cancer treatment as compared to conventional increase in survival rate. This study mainly focuses on the effect of palliative drug therapy on quality of life.     

吉西他滨联合顺铂治疗复发性晚期头颈部癌的临床研究

 目的 评价吉西他滨联合顺铂治疗复发性晚期头颈部肿瘤的疗效及毒副作用。方法 对复治的晚期头颈部肿瘤患者，给予GEM 1000mg／m²静滴，第1、8d，每周期CDDP 60mg／m²，静滴（分5次第1-5d），21d为1周期，2周期后评定疗效，平均3．52个周期。结果 27例可评价疗效，完全缓解1例，部分缓解7例，总有效率29．63％，中位缓解期4．4个月，中位生存期9个月。毒副作用主要为剂量限制性毒性，表现为骨髓抑制。结论 吉西他滨加顺铂可作为复发性晚期头颈部肿瘤的挽救性化疗方案。     

以顺铂为主联合化疗用于头颈部癌的诱导化疗疗效观察

目的 :探讨以顺铂为主的联合化疗在头颈部癌手术前诱导化疗中的价值 ,对手术前诱导化疗的疗效进行了回顾性分析。方法 :1986年～ 1998年 ,对 2 13例头颈部癌进行手术前诱导化疗。以顺铂 平阳霉素 甲氨蝶呤 (DPM方案 )或以顺铂 5 氟脲嘧啶 (DF方案 ) ,用 1～ 2个周期。结果 :诱导化疗后的有效率为 :DPM组为 4 2 4 % ,DF组为 4 5 % ,两组差异无显著性。总的 3年生存率为 5 1 5 % ,5年生存率为 4 4 8%。结论 :以顺铂为主的联合化疗方案对头颈部癌是安全有效的 ,综合治疗对头颈部癌是有效的治疗方法。     

Efficacy and Tolerance of Carboplatin plus Cetuximab (Simplified EXTREME Regimen) in Patients with Recurrent and/or Metastatic Head and Neck Squamous Cell Carcinoma

AimsThe EXTREME regimen is the standard for recurrent and/or metastatic head and neck squamous cell carcinoma (HNSCC). However, many patients have a poor performance status and/or comorbidities, making them unfit for this regimen. We have treated them with carboplatin and cetuximab (simplified EXTREME regimen) since 2007. Our aim was to assess the efficacy and tolerance of this regimen in this frail population.Materials and methodsA retrospective chart review of all patients treated with the simplified EXTREME regimen for recurrent and/or metastatic HNSCC in three academic hospitals between 2007 and 2017 was carried out. The primary end point was overall survival. Secondary end points were progression-free survival (PFS), overall response rate (ORR) and toxicity.ResultsOne hundred and three patients were included. The median age was 63 years, 40% had performance status 2–3. The median follow-up was 30.2 months. The median overall survival and PFS were 7.2 and 3.7 months, respectively. The median overall survival was 10.1 months in patients with performance status 0–1 versus 4.6 months in patients with performance status 2–3 (P = 0.01). ORR was 39%. Acute grade 3–4 haematological and non-haematological toxicity rates were 25.2% and 27.2%, respectively. Patients with grade 1 or more skin toxicity had a higher ORR (hazard ratio = 3.44; P = 0.03), a prolonged overall survival (hazard ratio = 0.37; P < 0.0001) and PFS (hazard ratio = 0.29; P < 0.0001). During treatment, 29% of patients had pain reduction, 13.5% had weight gain and 17.2% had an improvement in performance status.ConclusionsThis is the largest cohort of patients treated with simplified EXTREME for HNSCC. It was well tolerated, with a high ORR. Interestingly, skin toxicity correlated with treatment efficacy.     

Role of PET/CT in Treatment Planning for Head and Neck Cancer Patients Undergoing Definitive Radiotherapy

Background: In this study, we aimed to investigate the benefits of 18F-deoxyglucose positron emissiontomography/computed tomography (FGD-PET/CT) imaging for staging and radiotherapy planning in patientswith head and neck cancer undergoing definitive radiotherapy. Materials and Methods: Thirty-seven headand neck cancer patients who had undergone definitive radiotherapy and PET/CT at the Uludag UniversityMedical Faculty Department of Radiation Oncology were investigated in order to determine the role of PET/CTin staging and radiotherapy planning. Results: The median age of this patient group of 32 males and 5 femaleswas 57 years (13-84years). The stage remained the same in 18 cases, decreased in 5 cases and increased in 14cases with PET/CT imaging. Total gross tumor volume (GTV) determined by CT (GTVCT-Total) was increasedin 32 cases (86.5%) when compared to total GTV determined by PET/CT (GTVPET/CT-Total). The GTV of theprimary tumor determined by PET/CT (GTVPET/CT) was larger in 3 cases and smaller in 34 cases comparedto that determined by CT (GTVCT). The GTV of lymph nodes determined by PET/CT (GTVLNPET/CT) waslarger in 20 cases (54%) and smaller in 12 cases (32.5%) when compared to GTV values determined by CT(GTVLNCT). No pathological lymph nodes were observed in the remaining five cases with both CT and PET/CT. Conclusions: We can conclude that PET/CT can significantly affect both pretreatment staging and assessedtarget tumor volume in patients with head and neck cancer. We therefore recommend examining such cases withPEC/CT before treatment.     

头颈肿瘤继发淋巴水肿的评估与治疗进展

淋巴水肿是头颈肿瘤患者经治后常见的不良反应,若缺乏系统评估与治疗,会发展为相关部位或器官中至重度纤维化,导致吞咽、言语等功能障碍,同时可能引起患者焦虑乃至心理问题,严重影响患者的生活质量。随着综合治疗策略的发展,头颈肿瘤患者的生存期不断延长,继发淋巴水肿的预防和诊治显得日益重要。患者头颈肿瘤继发淋巴水肿症状以CRO评估、物理治疗为主的模式尚未取得令人满意的结果。不过现有治疗评估体系提示继发性淋巴水肿可控、可防治。全文对近年来头颈肿瘤继发淋巴水肿的评估方法,以及诊疗技术的研究进展进行综述,旨在为评估和改善头颈肿瘤患者继发淋巴水肿症状及减少远期并发症提供理论依据。     

Cisplatin as Second Line Chemotherapy in Advanced or Recurrent Squamous Cell Carcinoma of Head and Neck Region

Thirty-two patients with advanced or recurrent carcinoma of the head and neck were treated with cis-dichlorodiaminoplatinum II (CDDP) 75 mg/m² every third week as second line chemotherapy. The response rate was 3 per cent with one complete and no partial responders, 16 patients with no change and 10 with progressive disease. Five were not evaluated concerning response. Median time to progression was 12 weeks (confidence limits 10--17 weeks) and median survival time 21 weeks (confidence limits 10 to 33 weeks, range 4 to 109). No severe hematologic toxicity was seen. Two patients had progressive polyneuropathy, one had a severe decline in Cr-EDTA-clearance and in one decline in auditory function was suspected. It is concluded that CDDP in this schedule has no role as second line chemotherapy in advanced cancer of head and neck.     

Efficacy and Safety of Concomitant Chemoradiotherapy with Cisplatin and Docetaxel in Patients with Locally Advanced Squamous Cell Head and Neck Cancers

Background: Chemoradiation (CRT) using cisplatin-based regimens has become the standard of care in thetreatment of squamous cell head and neck cancers (SCHNC). The impact of taxanes as radiosensitizing agentswith concurrent CRT regimens is unknown. We therefore retrospectively evaluated the efficacy and tolerabilityof a weekly cisplatin+docetaxel combination with CRT in locally advanced SCHNC. Methods: Sixty-six patientswith locally advanced SCHNC (39.4% stage IV, 53% stage III, and 7.6% stage II) were assessed retrospectively.Total radiation dose to the PTV of gross disease (primary and/or node) was 70 Gy/ 35 fractions, 5 fractions perweek. Minimum doses of 60 Gy and 50 Gy were administered to PTVs of elective high risk and low risk disease,respectively. Chemotherapy (CT) consisted of weekly cisplatin (20 mg/m2)+docetaxel (20 mg/m2) concurrentlywith RT. Results: The median age of the patients was 58 years (range, 32-77). Objective response rate was 83.3%.The 2-year progression-free survival (PFS) and overall survival (OS) were 75.7% and 78.3%, respectively.The most common grade 3 and 4 toxicities were mucositis (36.4%), nausea and vomiting (12.1%), neutropenia(4.5%). Conclusion: Weekly cisplatin and docetaxel concurrent with RT for locally advanced SCHNC was foundtolerable with high efficacy.