PHASE II STUDY OF CONCURRENT CHEOMORADIOTHERAPY FOR LARYNGEAL PRESERVATION USING CISPLATIN ALONE
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概要
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To improve disease specific survival (DSS) and avoid laryngectomy in patients with Stage II to IV resectible cancer in the oropharynx, hypopharynx and supraglottis, forty-two cases registered in a phase II non-randomized prospective study on concurrent chemoradiotherapy using Cisplatin (CDDP) from May 1992 to June 1999. Median follow-up time was 42 months (6-118 months). Definitive radiation dose was 66Gy/30F/7.5weeks, except for the cases evaluated for scheduled surgery at 40 to 45Gy. Two cycles of chemotherapy (20mg/m2 of CDDP, days 1, 2, 4, 5) were administered during the overall treatment time.T3-4 was 50% (2 T1, 19 T2, 14 T3, 7 T4), and Stage III & IV was 79% (1 Stage I, 8 Stage II, 13 Stage III, 20 Stage IV). Primary sites were oropharygeal anterior wall (8), oropharyngeal posterior wall (3), hypopharynx (19) and supraglottis (12). Five-year DSS was 81% and 5-year local control rate was 76% in all 42 cases. The complete response rate within 2 months after RT completion was 36/42 (86%) for the primary site and 18/24 (75%) for the neck. The laryngeal preserving rate was 63% at 5 years. These data were compared with those of the control cases treated with RT+Surgery, which has been selected from a historical database for the matched pair analysis. Five-year DSS and laryngeal preservation rate in the chemoradiation group were significantly better (p=0.0263 and p=0.0085) than those (51% and 40%) in the control group, respectively. Only one Grade 4 complication was shown as leucocytopenia and pneumonia but was recovered.It was concluded that concurrent chemoradiation using CDDP appears to result in distinct improvement of DSS and laryngeal preservation.
- 日本頭頸部癌学会の論文
日本頭頸部癌学会 | 論文
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