摘要
化疗是局部晚期头颈癌的重要治疗手段之一,但其使用方案仍待探讨。联合应用顺铂与5-氟尿嘧啶一直被视为标准新辅助治疗,并被证明有利于保存手术患者的器官,提高可手术切除及不可手术切除患者的远期生存效果。新近的研究发现,在顺铂与5-氟尿嘧啶的标准诱导化疗中增加紫杉烷(taxane)、多烯紫杉醇(docetaxel)或紫杉醇(paclitaxel),可进一步改善有效率和生存结果。越来越多的Ⅲ期临床试验资料支持在顺铂与5-氟尿嘧啶的标准诱导化疗方案中增加多烯紫杉醇或紫杉醇,使之成为疗效更好、毒性更小的诱导化疗方案。将诱导化疗与同期化放疗结合的序列治疗方案也在研究之中,旨在进一步提高远期生存效果。在顺铂与5-氟尿嘧啶方案中增加多烯紫杉醇或紫杉醇的诱导方案也在评价之中,序列治疗方案与标准治疗的疗效比较的随机试验也在进行中,有望为局部晚期头颈癌患者提供新的治疗方案。
Chemotherapy is an integral component of the management of patients with locally advanced head and neck cancer, though the optimal use of chemotherapy remains to be defined. The combination of a platinum agent and 5- fluorouracil has been used as the standard neoadjuvant treatment and has been shown to permit organ preservation in operable patients and improve long-term survival outcomes in operable and inoperable patients. Recently, the addition of a taxane, docetaxel or paclitaxel, to standard platinum plus 5-fluorouracil induction chemotherapy has been shown to further improve response rates and survival outcomes. Phase Ⅲ data are emerging to support combinations of docetaxel or paclitaxel with a platinum plus 5-fluorouracil as a new, more effective and less toxic standard for neoadjuvant chemotherapy. Sequential treatment regimens, incorporating a combination of induction chemotherapy and chemoradiation, are also under study in efforts to further improve long-term survival outcomes. Induction regimens incorporating docetaxel or paclitaxel with a platinum plus 5-fluorouracil are under evaluation in this setting. Randomized trials comparing a sequential treatment approach with standard therapies are also being undertaken and will likely define a new treatment paradigm for patients with locally advanced head and neck cancer.
出处
《中国口腔颌面外科杂志》
CAS
2006年第5期322-329,共8页
China Journal of Oral and Maxillofacial Surgery
关键词
头颈癌
化疗
新辅助治疗
多烯紫杉醇
紫杉醇
Head and neck cancer
Chemotherapy
Neoadjuvant
Docetaxel
Paclitaxel
