每周一次低剂量顺铂同步放疗治疗局部晚期头颈部鳞状细胞癌的疗效和安全性

IF 1.6 4区医学 Q2 OTORHINOLARYNGOLOGY

Auris Nasus Larynx Pub Date : 2025-05-02 DOI:10.1016/j.anl.2025.04.012

Akihisa Tanaka , Ari Nishimura , Shinji Mikami , Takahiro Kimura , Kaori Yamaki , Fumiaki Isohashi , Hirokazu Uemura , Tadashi Kitahara

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引用次数: 0

摘要

目的低剂量每周顺铂并发放疗（wCRT）被认为是目前标准的高剂量每周顺铂并发放疗（twCRT）治疗局部晚期头颈部鳞状细胞癌（LA-HNSCC）的潜在替代方案，因为其毒性降低。本研究旨在探讨wCRT治疗LA-HNSCC的疗效和安全性。方法回顾性分析了2007年1月至2021年12月期间接受明确wCRT作为一线治疗的III期或IV期LA-HNSCC患者。排除远处转移或p16阳性口咽癌患者或接受诱导化疗的患者。结果入选患者78例，年龄≥70岁32例。2年和5年总生存率（OS）分别为81.0%和63.5%，完全缓解率为89.7%。88.5%的患者给予≥200mg /m²的累积顺铂剂量，在单因素和多因素分析中发现这是OS的重要预后因素。急性不良事件通常是可控的，非血液学毒性较少，可能是由于多学科支持治疗。结论虽然twCRT仍是标准疗法，但wCRT是治疗LA-HNSCC可行且毒性较低的替代疗法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Efficacy and safety of definitive low-dose weekly cisplatin with concurrent radiotherapy for locally advanced head and neck squamous cell carcinoma

Objective

Low-dose weekly cisplatin with concurrent radiotherapy (wCRT) is considered a potential alternative to the current standard of high-dose three-weekly cisplatin with concurrent RT (twCRT) for the treatment of locally advanced head and neck squamous cell carcinoma (LA-HNSCC) owing to its reduced toxicity. This study aimed to investigate the efficacy and safety of wCRT for LA-HNSCC treatment.

Methods

This retrospective analysis included patients with stage III or IV LA-HNSCC who underwent definitive wCRT as the first-line treatment between January 2007 and December 2021. Patients with distant metastases or p16-positive oropharyngeal cancer or who had undergone induction chemotherapy were excluded.

Results

Seventy-eight eligible patients were identified, 32 of whom were aged ≥70 years. The 2- and 5-year overall survival (OS) rates were 81.0% and 63.5%, respectively, with a complete response rate of 89.7%. A cumulative cisplatin dose of ≥200 mg/m² was administered to 88.5% of the patients and found to be a significant prognostic factor for OS in both univariate and multivariate analyses. Acute adverse events were generally manageable, with fewer non-haematological toxicities, likely owing to multidisciplinary supportive care.

Conclusion

Although twCRT remains the standard, wCRT appears a viable and less toxic alternative for treating LA-HNSCC.

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来源期刊

Auris Nasus Larynx 医学-耳鼻喉科学

CiteScore

3.40

自引率

5.90%

发文量

169

审稿时长

30 days

期刊介绍： The international journal Auris Nasus Larynx provides the opportunity for rapid, carefully reviewed publications concerning the fundamental and clinical aspects of otorhinolaryngology and related fields. This includes otology, neurotology, bronchoesophagology, laryngology, rhinology, allergology, head and neck medicine and oncologic surgery, maxillofacial and plastic surgery, audiology, speech science. Original papers, short communications and original case reports can be submitted. Reviews on recent developments are invited regularly and Letters to the Editor commenting on papers or any aspect of Auris Nasus Larynx are welcomed. Founded in 1973 and previously published by the Society for Promotion of International Otorhinolaryngology, the journal is now the official English-language journal of the Oto-Rhino-Laryngological Society of Japan, Inc. The aim of its new international Editorial Board is to make Auris Nasus Larynx an international forum for high quality research and clinical sciences.