Clinical Studies on Induction Chemotherapy Followed by Concurrent Lobaplatin Chemoradiotherapy for Locally Advanced Head and Neck Squamous Cell Carcinoma
Abstract: Objective: To investigate the efficacy and the adverse effects in locally advanced squamous cell carcinoma of the head and neck treated with the induction chemotherapy (ICT), followed by intensity- modulated radiotherapy (IMRT) and concurrent chemo therapy (CCC). Methods: Chose 16 stages III - IV head and neck squamous cell carcinoma patients with no distant metastases who were enrolled in this study. All people were treated with a protocol of ICT 2 cycles (21 days/cycle) with Docetaxel, Cisplatin and Fluorouracil (TPF). After 2 cycles of induction chemotherapy, it began the concurrent chemoradiotherapy in the third week with the dose of 95% PGTVp 69.96 Gy/33f, 95% PGTVnd 69.96 Gy/33f, 90% PTV1 60.06 Gy/33f, 90% PTV2 50.96 Gy/28f. Concurrent chemotherapy was 50 mg/m2 Lobaplatin d1, 21 days/cycle and a total of two cycles. Additionally, a month after the chemotherapy, an adjuvant chemotherapy, with the same scheme as that of induction chemotherapy curative effect of induction chemotherapy was 81%, with CR 6%, PR 75%, NC 19% and PD 0%. The overall response rate was 94%, with CR 38%, PR 56 %, NC 6% and PD 0%. Additionally, a month after the chemotherapy, an adjuvant chemotherapy had the same scheme as that of induction chemotherapy. Results: The overall response rate was 94%. The 12 months overall survival rate was 92%. The main side effects from induction chemotherapy were thrombopenia with 1 case, leukopenia with 6 cases, neutropenia with 5 cases in grade 3 to 4. The main side effects from concurrent lobaplatin chemoradio therapy were oral mucositis with 4 cases, thrombopenia with 11 cases, leukopenia with 7 cases, neutropenia with 5 cases in grade 3 to 4. The reactions of alimentary tract were relatively reduced. The grade glutamic-pyruvic transaminase was 2 cases slightly higher. Conclusions: 1) The main side effect from concurrent lobaplatin chemoradiotherapy was thrombopenia. Other side effects: digestive system and renal ears toxicity were soft. 2) The recent efficacy of the linduction chemotherapy followed by Con- current lobaplatin chemoradiotherapy was good, and the exact efficacy and side effects still needed further research to expand the number of cases.
文章引用: 陈 宇 , 吴伟莉 , 金 风 , 李媛媛 , 龙金华 , 龚修云 , 陈潇潇 , 黄诗颖 , 李卓玲 , 毛振华 , 周 亚 (2015) 诱导化疗联合洛铂同期放化疗治疗局部晚期头颈部鳞癌临床研究。 世界肿瘤研究， 5， 1-7. doi: 10.12677/WJCR.2015.51001
 Vermorken, J.B., Remenar, E., van Herpen, C., et al. (2007) Cisplatin, fluorouracil, and docetaxel in unresectable head and neck cancer. New England Journal of Medicine, 357, 1695-1704.
 Posner, M.R., Hershock, D.M., Blajman, C.R., et al. (2007) Cisplatin and fluorouracil alone or with docetaxel in head and neck cancer. New England Journal of Medicine, 357, 1705-1715.
 Paccagnella, A., Ghi, M.G., Loreqqian, L., et al. (2010) Concomitant chemoradiothe-rapy versus induction docetaxel, cisplatin and 5 fluorouracil (TPF) followed by concomitant chemoradiotherapy in locally advanced head and neck cancer: A phase II randomized study. Annals of Oncology, 21, 1515-1522.
 Nutting, C.M., Morden, J.P., Harrington, K.J., et al. (2011) Parotid-sparing intensity modulated versus conventional radiotherapy in head and neck cancer (PARSPORT): A phase 3 multicentre randomised controlled trial. Lancet Oncology, 12, 127-136.
 Nwizu, T., Ghi, M.G., Cohen, E.E. and Paccagnella, A. (2012) The role of chemotherapy in locally advanced head and neck squamous cell carcinoma. Seminars in Radiation Oncology, 3, 198-206.
 Specenier, P.M. and Vermorken, J.B. (2008) Recurrent head and neck cancer: Current treatment and future prospects. Expert Review of Anticancer Therapy, 8, 375-891.
 杨柳青, 秦叔逵 (2009) 第3代铂类药物洛铂的研究新进展. 临床肿瘤学杂志, 14, 1134-1139.
 刘秀峰, 秦叔逵 (2006) 洛铂的临床研究进展. 临床肿瘤学杂志, 11, 549-552.
 陈文玲, 朱严冰 (2008) 洛铂对喉癌细胞株Hep-2作用的初步探讨. 河北医科大学, 石家庄.
 付强, 宋安萍等 (2013) 洛铂联合足叶乙甙或伊立替康治疗广泛期小细胞肺癌的临床观察. 临床肿瘤学杂志, 18, 137-139.
 孙娜, 杨文燕 (2012) 洛铂治疗肿瘤的研究进展. 国际肿瘤学杂志, 39, 907-909.
 甘廷庆, 蓝东蔡, 正文, 刘汉锋 (2012) 吉西他滨联合洛铂治疗复发转移性鼻咽癌的临床观察. 中国实用医药, 6, 179-180.
 Long, G.X., Lin, J.W., Liu, D.B., et al. (2014) Single-arm multi-centre phase II study of lobaplatin combined with docetaxel for recurrent and metastatic nasopharyngeal carcinoma. Oral Oncology, 50, 717-720.