頭頸部扁平上皮癌進行例に対するDocetaxel, Cisplatin, 5-FU (TPF) 併用化学療法と放射線治療の検討
頭頸部扁平上皮癌進行例を対象にドセタキセル (DOC), シスプラチン (CDDP), 5-FUの3剤 (TPF) 併用化学療法の推奨用量, 有効性を検討した. また, TPF併用同時放射線化学療法 (同時CRTx) を施行し, 推奨用量, 有効性を検討した. さらに, TPF化学療法施行後に放射線治療をした群 (CTx後RTx群) と同時CRTx群の有効性, 副作用を比較した. Day1にDOCを投与し, 投与終了1時間後に5-FUの120時間 (Day1～5) 連続投与を開始し, Day4にCDDPを投与した. 放射線治療は, 同時CRTx群ではDay1から開始し, CTx後RTx群では化...
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| Published in | 日本耳鼻咽喉科学会会報 Vol. 108; no. 2; pp. 157 - 163 |
|---|---|
| Main Authors | , , , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English Japanese |
| Published |
一般社団法人 日本耳鼻咽喉科学会
20.02.2005
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0030-6622 1883-0854 |
| DOI | 10.3950/jibiinkoka.108.157 |
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| Abstract | 頭頸部扁平上皮癌進行例を対象にドセタキセル (DOC), シスプラチン (CDDP), 5-FUの3剤 (TPF) 併用化学療法の推奨用量, 有効性を検討した. また, TPF併用同時放射線化学療法 (同時CRTx) を施行し, 推奨用量, 有効性を検討した. さらに, TPF化学療法施行後に放射線治療をした群 (CTx後RTx群) と同時CRTx群の有効性, 副作用を比較した. Day1にDOCを投与し, 投与終了1時間後に5-FUの120時間 (Day1～5) 連続投与を開始し, Day4にCDDPを投与した. 放射線治療は, 同時CRTx群ではDay1から開始し, CTx後RTx群では化学療法終了3週間後に開始した. TPF化学療法の推奨用量はDOC 60, CDDP 70, 5-FU 750mg/m2/dayであり, 奏効率は95%であった. 同時CRTx群の推奨用量はDOC 50, CDDP 60, 5-FU 600mg/m2/dayであった. また, CTx後RTx群と同時CRTx群を比較すると, 奏効率は両方とも100%, CR率が各々87%, 84%と両群とも良好だが, 1年生存率は各々69%, 95%で同時CRTx群の方が有意に良好であった (p<0.05). CTx後RTx群は同時CRTx群より遠隔転移が多く, これが生存率に影響した. 同時CRTx群は白血球減少, 口内炎等副作用が強く出現するため, より全身管理が重要であるが, 良好な結果が得られた. |
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| AbstractList | 頭頸部扁平上皮癌進行例を対象にドセタキセル (DOC), シスプラチン (CDDP), 5-FUの3剤 (TPF) 併用化学療法の推奨用量, 有効性を検討した. また, TPF併用同時放射線化学療法 (同時CRTx) を施行し, 推奨用量, 有効性を検討した. さらに, TPF化学療法施行後に放射線治療をした群 (CTx後RTx群) と同時CRTx群の有効性, 副作用を比較した. Day1にDOCを投与し, 投与終了1時間後に5-FUの120時間 (Day1～5) 連続投与を開始し, Day4にCDDPを投与した. 放射線治療は, 同時CRTx群ではDay1から開始し, CTx後RTx群では化学療法終了3週間後に開始した. TPF化学療法の推奨用量はDOC 60, CDDP 70, 5-FU 750mg/m2/dayであり, 奏効率は95%であった. 同時CRTx群の推奨用量はDOC 50, CDDP 60, 5-FU 600mg/m2/dayであった. また, CTx後RTx群と同時CRTx群を比較すると, 奏効率は両方とも100%, CR率が各々87%, 84%と両群とも良好だが, 1年生存率は各々69%, 95%で同時CRTx群の方が有意に良好であった (p<0.05). CTx後RTx群は同時CRTx群より遠隔転移が多く, これが生存率に影響した. 同時CRTx群は白血球減少, 口内炎等副作用が強く出現するため, より全身管理が重要であるが, 良好な結果が得られた. |
| Author | 石戸谷, 淳一 香取, 秀明 山本, 馨 吉田, 高史 高橋, 優宏 佐久間, 康徳 松田, 秀樹 佐藤, 奈央 木村, 真知子 三上, 康和 佃, 守 田口, 享秀 池田, 陽一 廣瀬, 正二 谷垣, 裕二 堀内, 長一 |
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| References | 14) Forastiere A, Neuberg D: Eastern Cooperative Group (ECOG) pacritaxel studies in advanced head and neck cancer. Head Neck 1994; 16: 481 (abstr 35). 9) Schrijvers D, van Herpen C, Kerger J: Phase I-II study with docetaxel, cisplatin and 5-FU in patients with locally advanced inoperable squamous cell carcinoma of head and neck (SCCHN). Eur J Cancer 1999; 23: 128-131. 13) Dreyfuss A, Clark J: Docetaxel: An active drug for squamous cell carcinoma of head and neck. J Clin Oncol 1996; 14: 1672-1678. 16) Catimel G, Verwij J: Docetaxel (taxotere): An active drug for treatment of the treatment of the head and neck. Ann Oncol 1994; 5: 553-557. 5) Katori H, Tsukuda M: Phase I trial of concurrent chemoradiotherapy with docetaxel, cisplatin and 5-fluorouracil (TPF) in patients with locally advanced squamous cell carcinoma of the head and neck (SCCHN). British J Cancer 2004; 90: 348-352. 8) Colevas AD, Norris CM, Tisher RB, Lamb CC, Fried MP,: Pase I/II trial of outpatient docetaxel, cisplatin, 5-fluorouracil and Leucovorin (opTPFL) as induction for squamous cell carcinoma of head and neck (SCCHN). Am J Clin Oncol 2002; 25: 153-159. 7) Posner MR, Glisson B, Frenette G, Al-Sarraf M, Colevas AD,: Multicenter Phase I-II trial of docetaxel, cisplatin and fluorouracil induction chemotherapy for patients with locally advanced squamous cell carcinoma of head and neck. J Clin Oncol 2001; 19: 1096-1104. 11) 古川滋: 頭頸部扁平上皮癌に対するCDDP, 5-FU併用療法の検討. 横浜医学1992; 43: 55-70. 12) Paccagnella A, Orlando A: Phase III trial of initial chemotherapy in stage III or IV head and neck cancers: A study by the Gruppo di Studio sui Tumori della Testa e del Collo. J Natl Cancer Inst 1994; 86: 265-272. 1) Colevas AD, Busse PM, Norris CM, Fried M, Tisher RB,: Induction chemotherapy with docetaxel, cisplatin, fluorouracil and leucovorin for squamous cell carcinoma of head and neck: A phase I/II trial, J Clin Oncol 1998; 16: 1331-1339. 3) Veterans Affairs Laryngeal Cancer Study Group: Induction chemotherapy plus radiation compared with surgery plus radiation in patients with advanced laryngeal cancer. N Engl J Med 1991; 324: 1685-1689. 2) Lefebvre J, Chevalier D: Larynx preservation in pyriform sinus cancer: Preliminary results of a European Organization for Research and Treatment of Cancer phase III trial. J Natl Cancer Inst 1996; 88: 890-898. 4) Kish J, Ensley J: A randomized trial of cisplatin (CACP) +5-fluorouracil (5-FU) infusion and CACP+5-FU bolus for recurrent and advanced squamous cell carcinoma of the head and neck. Cancer 1985; 56: 2740-2744. 15) Forastiere A, Neuberg D: Phase II evaluation of taxol in advanced head and neck cancer: An Eastern Cooperative Oncology Group trial. Monogor Natl Cancer Inst 1993; 15: 181-184. 17) Couteau C, Leyvraz S: A Phase II study of docetaxel in squamous cell carcinoma (SCC) of the head and neck. Proc Am Soc Clin Oncol 1996; 15: 315. 19) Mauer A, Masters G: Phase I study of docetaxel with concomitant thoracic radiation therapy. J Clin Oncol 1998; 16: 159-164. 6) Colevas AD, Norris CM, Tisher RB, Fried M, Gomolin HI,: Pase II trial of docetaxel, cisplatin, fluorouracil and Leucovorin as induction for squamous cell carcinoma of head and neck. J Clin Oncol 1999; 17: 3503-3511. 10) Jannis J, Papadakou M, Xidakis E: Combination chemotherapy with docetaxel, cisplatin and 5-fluorouracil in previously treated patients with advanced/recurrent head and neck cancer. Am J Clin Oncol 2000; 23: 128-131. 18) Fujii H, Sasaki Y: An early phase II study of docetaxel (Taxotere) in patients with head and neck cancer. Proc Am Soc Clin Oncol 1995; 14: 298 (abstr 859). 20) Taylor IV S, Murthy A: Randomized comparison of neoadjuvant cisplatin and fluorouracil infusion followed by radiation versus concomitant treatment in advanced head and neck cancer. J Clin Oncol 1994; 12: 385-395. |
| References_xml | – reference: 6) Colevas AD, Norris CM, Tisher RB, Fried M, Gomolin HI,: Pase II trial of docetaxel, cisplatin, fluorouracil and Leucovorin as induction for squamous cell carcinoma of head and neck. J Clin Oncol 1999; 17: 3503-3511. – reference: 7) Posner MR, Glisson B, Frenette G, Al-Sarraf M, Colevas AD,: Multicenter Phase I-II trial of docetaxel, cisplatin and fluorouracil induction chemotherapy for patients with locally advanced squamous cell carcinoma of head and neck. J Clin Oncol 2001; 19: 1096-1104. – reference: 18) Fujii H, Sasaki Y: An early phase II study of docetaxel (Taxotere) in patients with head and neck cancer. Proc Am Soc Clin Oncol 1995; 14: 298 (abstr 859). – reference: 5) Katori H, Tsukuda M: Phase I trial of concurrent chemoradiotherapy with docetaxel, cisplatin and 5-fluorouracil (TPF) in patients with locally advanced squamous cell carcinoma of the head and neck (SCCHN). British J Cancer 2004; 90: 348-352. – reference: 1) Colevas AD, Busse PM, Norris CM, Fried M, Tisher RB,: Induction chemotherapy with docetaxel, cisplatin, fluorouracil and leucovorin for squamous cell carcinoma of head and neck: A phase I/II trial, J Clin Oncol 1998; 16: 1331-1339. – reference: 8) Colevas AD, Norris CM, Tisher RB, Lamb CC, Fried MP,: Pase I/II trial of outpatient docetaxel, cisplatin, 5-fluorouracil and Leucovorin (opTPFL) as induction for squamous cell carcinoma of head and neck (SCCHN). Am J Clin Oncol 2002; 25: 153-159. – reference: 14) Forastiere A, Neuberg D: Eastern Cooperative Group (ECOG) pacritaxel studies in advanced head and neck cancer. Head Neck 1994; 16: 481 (abstr 35). – reference: 10) Jannis J, Papadakou M, Xidakis E: Combination chemotherapy with docetaxel, cisplatin and 5-fluorouracil in previously treated patients with advanced/recurrent head and neck cancer. Am J Clin Oncol 2000; 23: 128-131. – reference: 3) Veterans Affairs Laryngeal Cancer Study Group: Induction chemotherapy plus radiation compared with surgery plus radiation in patients with advanced laryngeal cancer. N Engl J Med 1991; 324: 1685-1689. – reference: 13) Dreyfuss A, Clark J: Docetaxel: An active drug for squamous cell carcinoma of head and neck. J Clin Oncol 1996; 14: 1672-1678. – reference: 2) Lefebvre J, Chevalier D: Larynx preservation in pyriform sinus cancer: Preliminary results of a European Organization for Research and Treatment of Cancer phase III trial. J Natl Cancer Inst 1996; 88: 890-898. – reference: 16) Catimel G, Verwij J: Docetaxel (taxotere): An active drug for treatment of the treatment of the head and neck. Ann Oncol 1994; 5: 553-557. – reference: 9) Schrijvers D, van Herpen C, Kerger J: Phase I-II study with docetaxel, cisplatin and 5-FU in patients with locally advanced inoperable squamous cell carcinoma of head and neck (SCCHN). Eur J Cancer 1999; 23: 128-131. – reference: 12) Paccagnella A, Orlando A: Phase III trial of initial chemotherapy in stage III or IV head and neck cancers: A study by the Gruppo di Studio sui Tumori della Testa e del Collo. J Natl Cancer Inst 1994; 86: 265-272. – reference: 4) Kish J, Ensley J: A randomized trial of cisplatin (CACP) +5-fluorouracil (5-FU) infusion and CACP+5-FU bolus for recurrent and advanced squamous cell carcinoma of the head and neck. Cancer 1985; 56: 2740-2744. – reference: 11) 古川滋: 頭頸部扁平上皮癌に対するCDDP, 5-FU併用療法の検討. 横浜医学1992; 43: 55-70. – reference: 19) Mauer A, Masters G: Phase I study of docetaxel with concomitant thoracic radiation therapy. J Clin Oncol 1998; 16: 159-164. – reference: 15) Forastiere A, Neuberg D: Phase II evaluation of taxol in advanced head and neck cancer: An Eastern Cooperative Oncology Group trial. Monogor Natl Cancer Inst 1993; 15: 181-184. – reference: 17) Couteau C, Leyvraz S: A Phase II study of docetaxel in squamous cell carcinoma (SCC) of the head and neck. Proc Am Soc Clin Oncol 1996; 15: 315. – reference: 20) Taylor IV S, Murthy A: Randomized comparison of neoadjuvant cisplatin and fluorouracil infusion followed by radiation versus concomitant treatment in advanced head and neck cancer. J Clin Oncol 1994; 12: 385-395. |
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| Snippet | 頭頸部扁平上皮癌進行例を対象にドセタキセル (DOC), シスプラチン (CDDP), 5-FUの3剤 (TPF) 併用化学療法の推奨用量, 有効性を検討した. また, TPF併用同時放射線化学療法 (同時CRTx) を施行し, 推奨用量, 有効性を検討した. さらに, TPF化学療法施行後に放射線治療をした群... |
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| SubjectTerms | シスプラチン ドセタキセル 放射線化学療法 頭頸部扁平上皮癌 |
| Title | 頭頸部扁平上皮癌進行例に対するDocetaxel, Cisplatin, 5-FU (TPF) 併用化学療法と放射線治療の検討 |
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