山东大学耳鼻喉眼学报 ›› 2019, Vol. 33 ›› Issue (4): 10-17.doi: 10.6040/j.issn.1673-3770.1.2019.027

• 专家笔谈 • 上一篇    下一篇

诱导化疗在局部晚期下咽癌治疗中的意义

崔晓波*()   

  1. 内蒙古医科大学附属医院耳鼻咽喉科，内蒙古 呼和浩特 010050
  • 收稿日期:2019-05-07 出版日期:2019-07-16 发布日期:2019-07-22
  • 通讯作者: 崔晓波 E-mail:cxbgh@sina.com
  • 作者简介:崔晓波，内蒙古医科大学附属医院耳鼻咽喉头颈外科主任，学科带头人，硕士研究生导师。内蒙古医学会耳鼻咽喉头颈外科分会主任委员；中华医学会耳鼻咽喉头颈外科分会第十、第十一、第十二届委员会委员；中国医师协会耳鼻咽喉科医师分会常委；中华医学会耳鼻咽喉头颈外科头颈学组委员。《中华耳鼻咽喉头颈外科杂志》《中华耳科学杂志》《中国耳鼻咽喉头颈外科杂志》《山东大学耳鼻喉眼学报》《内蒙古医科大学学报》《内蒙古医学杂志》等期刊编委。主要研究方向：头颈肿瘤的基础与临床研究。近年来，在国内外期刊上发表论文40余篇，其中SCI收录论文6篇。承担多项国家级及自治区级科研课题

Significance of induction chemotherapy in late treatment of locally advanced hypo-pharyngeal cancer

Xiaobo CUI*()   

  1. Department of Otolaryngology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, Inner Mongolia, China
  • Received:2019-05-07 Online:2019-07-16 Published:2019-07-22
  • Contact: Xiaobo CUI E-mail:cxbgh@sina.com

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摘要：

下咽癌发生位置隐蔽，早期症状不明显，超过2/3的下咽癌临床上初诊时为中晚期，是头颈肿瘤中预后较差的一种恶性肿瘤。近年来，倡导手术、放疗与化疗相结合的综合治疗模式以改善预后。诱导化疗在器官保留以及减少远处转移上的治疗价值日渐受到重视。但在实际临床工作中，主管医师对指南和各治疗手段利弊的理解以及临床经验的差异，诱导化疗在局部晚期下咽癌治疗中的作用仍存在争议。如何根据患者的全身和局部情况在众多的治疗方法中选择最合理的治疗手段是下咽癌治疗过程中一直在探讨的问题。通过文献回顾和个案剖析讨论诱导化疗在局部晚期下咽癌治疗中的作用。

关键词: 下咽癌, 诱导化疗, 器官保留, 个体化治疗

Abstract:

Early symptoms of hypopharyngeal cancer were not obvious because tumorigenesis in concealed areas. Almost 2/3 of hypopharyngeal cancer were diagnosed as middle and advanced stage, when first seeing a doctor.It is a malignant tumor with poor prognosis in head and neck tumors. In recent years, in order to improve the prognosis, we advocate a comprehensive treatment model combining surgery, radiotherapy and chemotherapy. Value of induction chemotherapy has been noticed in organ preservation and metastasis rate reduction. But in the actual clinical work, the role of induction chemotherapy (IC) in the treatment of locally advanced hypopharyngeal cancer has been disputed because every physicians′ understanding of the advantages and disadvantages of the guidelines and treatment methods and differences in clinical experience. How to choose the most reasonable one based on the patients′general and local conditions from many different treatment methods is an issue that has been explored in during treatment of hypopharyngeal cancer. This paper points out the author′s individual experience the induction chemotherapy in treatment of locally advanced hypopharyngeal cancer by literature review and case analyses.

Key words: Hypopharyngeal neoplasms, Induction chemotherapy, Organ preservation, Individualized treatment

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  • R767

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1 屠规益, 胡郁化. 下咽癌的外科治疗[J]. 中华耳鼻咽喉科杂志, 1986, 12: 85- 87.
2 张宗敏, 唐平章, 徐震纲, 等. 下咽鳞癌不同治疗方案的临床分析[J]. 中华肿瘤杂志, 2005, 27 (1): 48- 51.
doi: 10.3760/j.issn:0253-3766.2005.01.013
ZHANG Zongmin , TANG Pingzhang , XU Zhengang , et al. Long-term results of different treatment modalities in 464 hypopharyngeal squamous-cell carcinoma patients[J]. Chin J Oncol, 2005, 27 (1): 48- 51.
doi: 10.3760/j.issn:0253-3766.2005.01.013
3 Ma J , Liu Y , Huang XL , et al. Induction chemotherapy decreases the rate of distant metastasis in patients with head and neck squamous cell carcinoma but does not improve survival or locoregional control: A meta-analysis[J]. Oral Oncol, 2012, 48 (11): 1076- 1084.
doi: 10.1016/j.oraloncology.2012.06.014
4 Bauman J , Langer C , Quon H , et al. Induction chemotherapy with cetuximab, carboplatin and paclitaxel for the treatment of locally advanced squamous cell carcinoma of the head and neck[J]. Experimental and Therapeutic Medicine, 2013, 5 (4): 1247- 1253.
doi: 10.3892/etm.2013.948
5 Janoray G , Pointreau Y , Garaud P , et al. Long-term results of a multicenter randomized phase Ⅲ trial of induction chemotherapy with cisplatin, 5-fluorouracil, ±docetaxel for larynx preservation[J]. J Natl Cancer Inst, 2016, 108 (4): djv368.
doi: 10.1093/jnci/djv368
6 廖恺, 毕卓菲, 何艳, 等. TPF或PF方案诱导化疗治疗局部晚期头颈鳞癌的Meta分析[J]. 循证医学, 2012, 12 (5): 278- 285.
doi: 10.3969/j.issn.1671-5144.2012.05.007
LIAO Kai , BI Zhuofei , HE Yan , et al. Induction chemotherapy with cisplatin and fluorouracil alone or with taxanes for locally advanced squamous-cell cancer of the head and neck: A meta-analysis[J]. J Evid-Based Med, 2012, 12 (5): 278- 285.
doi: 10.3969/j.issn.1671-5144.2012.05.007
7 Pointreau Y , Garaud P , Chapet S , et al. Randomized trial of induction chemotherapy with cisplatin and 5-fluorouracil with or without docetaxel for larynx preservation[J]. Journal of the National Cancer Institute, 2009, 101 (7): 498- 506.
doi: 10.1021/jf011209e
8 Fabregas JC , Loaiza-Bonilla A , Talebi TN , et al. Concurrent chemoradiotherapy versus induction chemotherapy followed by chemoradiotherapy (sequential approach) in the management of head and neck cancer[J]. Expert Rev Anticancer Ther, 2013, 13 (9): 1065- 1072.
doi: 10.1586/14737140.2013.829639
9 Voichita BA , Joshua P , Yang HS , et al. Current management of locally advanced head and neck cancer : the combination of chemotherapy with locoregional treatments[J]. Seminars in Oncology, 2014, 41 (6): 798- 806.
doi: 10.1053/j.seminoncol.2014.09.018
10 Cohen EE , Karrison TG , Kocherginsky M , et al. Phase Ⅲ randomized trial of induction chemotherapy in patients with N2 or N3 locally advanced head and neck cancer[J]. J Clin Oncol, 2014, 32 (25): 2735- 2743.
doi: 10.1200/JCO.2013.54.6309
11 Lefebvre JL . Laryngeal preservation in head and neck cancer: multidisciplinary approach[J]. Lancet Oncol, 2006, 7 (9): 747- 755.
doi: 10.1016/S1470-2045(06)70860-9
12 Tada Y , Maruya SI , Saotome T , et al. Phase Ⅰ/Ⅱ study of docetaxel, cisplatin and S-1 in locally advanced, recurrent and metastatic head and neck squamous cell carcinoma[J]. Oncol Lett, 2012, 4 (5): 898- 904.
doi: 10.3892/ol.2012.846
13 鲁光平, 潘骥群, 刘志标. DCF方案诱导化疗后手术治疗喉癌及下咽癌T2-3病变疗效分析[J]. 临床耳鼻咽喉头颈外科杂志, 2015, 29 (7): 585- 588.
doi: 10.13201/j.issn.1001-1781.2015.07.002
LU Guangping , PAN Jiqun , LIU Zhibiao . Efficacy analysis of sequential surgery after the DCF scheme induction chemotherapy in T2-3 laryngeal carcinoma and hypopharyngeal carcinoma[J]. J Clin Otorhinolaryngol Head Neck Surg, 2015, 29 (7): 585- 588.
doi: 10.13201/j.issn.1001-1781.2015.07.002
14 Denaro N , Russi EG , Lefebvre JL , et al. A systematic review of current and emerging approaches in the field of larynx preservation[J]. Radiother Oncol, 2014, 110 (1): 16- 24.
doi: 10.1016/j.radonc.2013.08.016
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