中华临床医师杂志（电子版）
中華臨床醫師雜誌（電子版）
중화림상의사잡지（전자판）
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2014年
14期
2623-2626
,共4页
邱幸生%刘宜敏%毕卓菲%谢德荣
邱倖生%劉宜敏%畢卓菲%謝德榮
구행생%류의민%필탁비%사덕영
头颈部肿瘤%癌,鳞状细胞%放射疗法%药物疗法
頭頸部腫瘤%癌,鱗狀細胞%放射療法%藥物療法
두경부종류%암,린상세포%방사요법%약물요법
Head and neck neoplasms%Carcinoma,squamous cell%Radiotherapy%Drug therapy
目的：观察局部进展期头颈部鳞状细胞癌术后放疗，同期多西他赛联合顺铂方案化疗的疗效，探讨提高术后放疗疗效的方法。方法回顾性分析2008年3月至2011年12月行术后同期放化疗的79例头颈部鳞状细胞癌患者治疗资料，原发灶位于口咽、喉或喉咽，术后有以下高危因素：淋巴结包膜外侵犯；手术切缘阳性；病理学为T4或N2、N3。根据复发风险处方照射剂量，同期多西他赛联合顺铂方案化疗，3周1次。用Kaplan-Meier法分析生存获益及无进展生存率，RTOG毒性标准评价放疗引起的急性与晚期毒性反应，NCI化疗毒性标准评价化疗毒性反应。结果中位随访38个月，全组共9例发生局部区域复发。2年局部区域控制率92%，2年无进展生存率75%，2年总体生存率87%。Ⅲ度或以上治疗相关毒性反应：粒细胞缺乏（59%），黏膜损伤（47%），口干（6%），肌纤维化（10%），吞咽困难（8%）及皮肤损伤（13%），9例患者发生咽瘘，无治疗相关死亡。结论局部进展期头颈部鳞状细胞癌术后放疗，同期多西他赛联合顺铂方案化疗是安全、有效的治疗手段。
目的：觀察跼部進展期頭頸部鱗狀細胞癌術後放療，同期多西他賽聯閤順鉑方案化療的療效，探討提高術後放療療效的方法。方法迴顧性分析2008年3月至2011年12月行術後同期放化療的79例頭頸部鱗狀細胞癌患者治療資料，原髮竈位于口嚥、喉或喉嚥，術後有以下高危因素：淋巴結包膜外侵犯；手術切緣暘性；病理學為T4或N2、N3。根據複髮風險處方照射劑量，同期多西他賽聯閤順鉑方案化療，3週1次。用Kaplan-Meier法分析生存穫益及無進展生存率，RTOG毒性標準評價放療引起的急性與晚期毒性反應，NCI化療毒性標準評價化療毒性反應。結果中位隨訪38箇月，全組共9例髮生跼部區域複髮。2年跼部區域控製率92%，2年無進展生存率75%，2年總體生存率87%。Ⅲ度或以上治療相關毒性反應：粒細胞缺乏（59%），黏膜損傷（47%），口榦（6%），肌纖維化（10%），吞嚥睏難（8%）及皮膚損傷（13%），9例患者髮生嚥瘺，無治療相關死亡。結論跼部進展期頭頸部鱗狀細胞癌術後放療，同期多西他賽聯閤順鉑方案化療是安全、有效的治療手段。
목적：관찰국부진전기두경부린상세포암술후방료，동기다서타새연합순박방안화료적료효，탐토제고술후방료료효적방법。방법회고성분석2008년3월지2011년12월행술후동기방화료적79례두경부린상세포암환자치료자료，원발조위우구인、후혹후인，술후유이하고위인소：림파결포막외침범；수술절연양성；병이학위T4혹N2、N3。근거복발풍험처방조사제량，동기다서타새연합순박방안화료，3주1차。용Kaplan-Meier법분석생존획익급무진전생존솔，RTOG독성표준평개방료인기적급성여만기독성반응，NCI화료독성표준평개화료독성반응。결과중위수방38개월，전조공9례발생국부구역복발。2년국부구역공제솔92%，2년무진전생존솔75%，2년총체생존솔87%。Ⅲ도혹이상치료상관독성반응：립세포결핍（59%），점막손상（47%），구간（6%），기섬유화（10%），탄인곤난（8%）급피부손상（13%），9례환자발생인루，무치료상관사망。결론국부진전기두경부린상세포암술후방료，동기다서타새연합순박방안화료시안전、유효적치료수단。
ObjectiveTo investigate the efficacy of postoperative radiotherapy concurrent with docetaxel plus cisplatin for locally advanced head and neck squamous cell carcinoma (HNSCC). MethodsThe records of 79 patients presenting with primary HNSCC from March 2008 to December 2011 were reviewed. Patients had squamous-cell carcinoma with primary sites at oropharynx, larynx, or hypopharynx; All had undergone macroscopically complete resection of disease with high-risk characteristics (any or all of the following: extracapsular extension of nodal disease, positive resection margins, pathological stage T4 primary or N2 or N3 node disease). All patients received postoperative radiotherapy concurrent with docetaxel plus cisplatin, dose was tailored to target volume according to pathological risk factors. Kaplan-Meier method were used to analyze survival benefit and progression free survival rate, treatment-related adverse effects were scored according to the Common Toxicity Criteria of the National Cancer Institute, version 2.0, for chemotherapy and according to RTOG criteria for radiotherapy.ResultsAfter a median follow-up of 38 months, local or regional recurrence as the first site of treatment failure occurred in 9 patients (16 percent). The estimated two-year rate of local and regional control was 92%. The estimated two-year rate of disease-free survival was 75%, overall survival was 87%. The treatment related severe (Grade 3 or higher) adverse effect were granulocytopenia(59%), mucositis(47%), xerostomia(6%), muscular fibrosis(10%), dysphagia (8%) and dermatitis (13%), Pharyngocutaneous fistula occurred in 9 patients. No treatment related death occurred.ConclusionTreatment with postoperative concurrent cisplatin plus docetaxel and radiotherapy is effective withan acceptable toxicity profile.
