- 期刊
Induction Chemotherapy with Docetaxel, Cisplatin and 5-Fluorouracil (TPF) in Locally Advanced Head and Neck Cancer: An Asian Single Institute Experience
以誘導式化療Docetaxel，Cisplatin和5-Fluorouracil治療局部晚期頭頸癌：單一亞洲醫學中心的經驗
摘要
背景：此回溯性研究為探討，使用引導化學治療(induction chemotherapy)來治療局部晚期頭頸癌(locally advanced head and neck cancer)，包含docetaxel, cisplatin和5-fluorouracil。此研究的目的是此化療使用在亞洲族群的療效，存活率，及副作用。方法：共33個頭頸癌病人，其癌症期別為第三與四期，活動功能介於ECOG0至2之間。使用的劑量為 Docetaxel 60mg/平方公尺, cisplatin 75mg/平方公尺而5-fluourocil 850mg/平方公尺連續給予4天。每三個禮拜給予一次化療，最多給予共三次化療。Kaplan-Meier存活曲線用來評估存活率。使用RECIST version 1.1和the expanded common toxicity criteria of the Clinical Trials Group of the National Cancer Institute of Canada 評估反應率(response rates)和化療毒性(toxicity)。結果：完全反應率(complete response rate)9.1%，部份反應率( partial response rate) 66.7%，疾病穩定率9.1%，而病情惡化率9.1%。一年整體存活率(overall survival rate)為93%，一年無進展存活率(progression free survival)為71.4%。共有20個病人(60.6%)有超過第三級血液毒性(hematologic toxicity)。在這二十個曾經發生中性球低下的病人中，有七個人有發燒，三個病人有急性腎衰竭。結論：Docetaxel, cisplatin和5-fluorouracil作為治療局部進展頭頸癌的引導化學治療是有效的。然而，中性球低下的發燒(febrile neutropenia)還是最重要的副作用，所以儘量避免使用在超過70歲的老人，或是提早使用白血球生長激素，使總白血球維持在2000/uL或許有幫助。
並列摘要
Background: A retrospective analysis of treating locally advanced head and neck cancer with induction chemotherapy with docetaxel plus cisplatin and 5-fluorouracil (TPF) among Taiwan patients. The purpose of this study was to report response rates, survival, and toxicity of induction chemotherapy with TPF among Asians.Methods: Thirty-three patients with stage III-IV head and neck cancer with good performance status (ECOG:0-2) were enrolled. Docetaxel 60 mg/m^2, cisplatin 75 mg/m^2, and 5-fluourocil 850 mg/m^2 for 4 days were administered every 3 weeks to, at the most, 3 cycles. The Kaplan-Meier survival curve was used to assess survival rates. Response rates and toxicities were graded by RECIST version 1.1 and the expanded common toxicity criteria of the Clinical Trials Group of the National Cancer Institute of Canada.Results: The complete response rate after induction of TPF was 9.1%, partial response rate was 66.7%, and the rate of stable disease was 9.1%, while the rate of progressive disease was 9.1%. The one-year overall survival rate was 93%, and one-year progression-free survival rate was 71.4%. Hematologic toxicities greater than grade 3 were noted in a total of 20 patients (60.6%). Seven cases among the twenty neutropenia patients developed febrile neutropenia. Three patients had acute renal failure.Conclusions: This TPF regimen is effective in Asian patients as induction chemotherapy for locally advanced squamous cell carcinoma of head and neck. However, febrile neutropenia remains the most important consideration. Avoiding use in the elderly aged more than 70 years of age or early preventive GCSF to keep total WBC ＞2000/uL be helpful.