[不能手术的口面部肿瘤同时进行放疗和动脉内化疗的预后因素]。

Strahlentherapie Pub Date : 1985-05-01
T Szepesi, B Stadler, G Hohenberg, K Hollmann, J Kühböck, G Mailath
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引用次数: 0

摘要

在1973年1月至1982年4月期间,66例可评估的晚期不能手术的口面部肿瘤患者接受了动脉内布来霉素和甲氨蝶呤联合放射治疗。32例患者既往未接受治疗,34例患者首次接受手术、放疗和/或化疗。博莱霉素15 mg,每日晨起经导管进入颈外动脉。夜间给予甲氨蝶呤25 mg,后给予亚叶酸钙3 mg,每8小时1次。累积剂量为300 mg博来霉素和500 mg甲氨蝶呤。博莱霉素给药4小时后,靶体积照射(单次剂量2 Gy,总剂量60 ~ 65 Gy)。总体缓解率为65%,其中17%完全缓解,48%部分缓解。在治疗开始时,骨骼的破坏似乎是最重要的指标。进一步的预后决定因素,如既往治疗,原发肿瘤的定位(分别为上颌和下颌骨口腔和口咽部)和局部区域淋巴结分期在生存时间上没有统计学意义,可能是由于同时化疗可能产生放射增敏效应。完全缓解是治疗结束后最重要的预后因素。完全缓解的患者显示中位无病生存期为56个月以上,中位生存期为82个月。急性反应是可逆的。只有14%的患者无法完成治疗。电子亲和放射增敏剂和高LET辐射可获得较好的效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Prognostic factors in the treatment of inoperable orofacial tumors with simultaneous radiotherapy and intra-arterial chemotherapy].

Between January 1973 and April 1982 66 evaluable patients with advanced inoperable orofacial tumours underwent intraarterial Bleomycin and Methotrexate with simultaneous radiotherapy in a prospective study. 32 patients had no previous treatment, 34 patients had initial surgery, radiotherapy and/or chemotherapy. 15 mg Bleomycin were administered through a catheter into the arteria externa carotis daily in the morning. 25 mg Methotrexate were given in the same way at night followed by 3 mg Calcium-Leucovorin i.m. every 8 hours. The cumulative dose was 300 mg Bleomycin and 500 mg Methotrexate. Four hours after the administration of Bleomycin the target volume was irradiated (single fraction 2 Gy, total dose 60 to 65 Gy). The overall response rate was 65% containing 17% complete and 48% partial remission. Destruction of the bone appeared to be the most important index at the start of the therapy. Further prognostic determinants as previous treatment, localisation of the primary tumours (maxilla and mandibula respectively oral cavity and oropharynx) and local regional lymphnode stage missed statistically significance in the survival time, may be due to a possible radiosensitizing effect of the simultaneous chemotherapy. Complete remission turned out to be the most important prognostic factor after the end of treatment. Patients responding with complete remission show a median disease free survival of 56+ months and a median survival time of 82 months. Acute reactions were reversible. Only in 14% of the patients the treatment could not be finished. Better results could be obtained by electron-affinic radiosensitizers and high LET radiation.

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