Docetaxel, Cisplatin and 5-Fluorouracil in Patients with Refractory, Recurrent, or Metastatic Squamous Cell Carcinoma of the Head and Neck

背景：回顧研究以docetaxel，cisplatin，和5-fluorouracil來治療頑固性、復發、或有遠處轉移的頭頸部鱗狀上皮細胞癌病人。病人和研究方法：我們回溯了25個合乎診斷是治療頑固性、復發或有遠處轉移的頭頸部鱗狀上皮細胞癌病人。其中有18個病人過去曾做過手術切除治療，且所有25個病人都曾經接受過化學藥物合併放射線治療，以及包含了cisplatin合併5-FU在內的化學藥物治療。這些病人都無法再做手術或局部的放射線治療。對於這樣的病人我們給予docetaxel加上cisplatin合併5-fluorouracil (TPF)的處方作為姑息性的化學藥物治療。其使用劑量如下：docetaxel第一天給予50mg/平方公尺；cisplatin也是在第一天給予50mg/平方公尺；而5-fluorouracil則以500mg/平方公尺/d給予3-5天。處方是以28天為一週期給予。結果：25個病人總共接受了78次docetaxel加上cisplatin合併5-fluorouracil的處方治療。平均每人有三次以上的療程。主要的治療毒性是對於骨髓的抑制，有52%的病人在治療期間曾發生過第三或第四級的中性白血球低下情況。有一病例由於嚴重的中性白血球低下而導致敗血症死亡。對於治療的結果，雖然沒有病人得到完全緩解，但有40%的病人是有局部的治療反應，而有32%的病人維持疾病穩定。平均存活時間為38周，可以存活超過一年的病人有28%。結論：我們回顧研究的結果認為：對於治療頑固性或復發或有遠處轉移的頭頸鱗狀上皮細胞癌病人，如果他們有好的日常體能狀態，那麼作為一個姑息性治療，較低劑量的docetaxel加上cisplatin合併5-fluorouracil是一個有治療效果而藥物毒性又可接受的處方。

關鍵字

頑固性頭頸癌；復發性頭頸癌；遠處轉移頭頸癌； docetaxel ； 5-fluorouracil ；順鉑

並列摘要

Background: This study retrospectively investigated the effects of one chemotherapy regimen-docetaxel, cisplatin, and 5-fluorouracil- in the treatment of patients with refractory, recurrent, or metastatic squamous cell carcinoma of the head and neck. Patients and Methods: We reviewed the medical history of 25 patients diagnosed with refractory, recurrent, or metastatic squamous cell carcinoma of the head and neck. Eightteen of the 25 patients had tumor resection, while all 25 patients received concurrent chemoradiotherapy with cisplatin and 5-FU as the primary therapy. For the 25 patients who had recurrent tumors that were unable to undergo further surgery or local radiotherapy, we applied a regimen consisting of docetaxel, cisplatin, and 5-fluorouracil (TPF) as palliative chemotherapy. The dosage was: docetaxel 50 mg/m^2 and cisplatin 50 mg/m^2 on day 1, followed by 5-fluorouracil 500 mg/m^2 per day for 3-5 days. This regimen was repeated every 28 days. Results: Twenty-five patients received a total 78 cycles of chemotherapy with the regimen docetaxel, cisplatin, and 5-fluorouracil. Each patient was given at least three cycles of chemotherapy on average. The main manifestation of toxicity was marrow suppression. Fifty-two percent of patients had Grade 3 or Grade 4 neutropenia during treatment. One patient died from septicemia associated with severe neutropenia. No complete response was achieved and 40% of patients had partial response, while 32% of patients obtained a stable disease condition. Median overall survival time was 38 weeks. Twenty-eight percent of patients survived for more than one year. Conclusions: As a palliative chemotherapy regimen, the dosing schedule of docetaxel, cisplatin, and 5-fluorouracil used in this study demonstrated its effectiveness and was well tolerated in patients with refractory, recurrent, or metastatic squamous cell carcinoma of the head and neck.

並列關鍵字

refractory ； recurrent ； metastatic ； head and neck ； docetaxel ； 5-fluorouracil ； cisplatin

國際替代計量

Docetaxel, Cisplatin and 5-Fluorouracil in Patients with Refractory, Recurrent, or Metastatic Squamous Cell Carcinoma of the Head and Neck

全文下載

主題瀏覽