中国癌症杂志 ›› 2013, Vol. 23 ›› Issue (12): 961-966.doi: 10.3969/j.issn.1007-3969.2013.12.005

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局部晚期头颈部鳞癌的非手术治疗

孔琳,陆嘉德   

  1. 复旦大学附属肿瘤医院放射治疗科,复旦大学上海医学院肿瘤学系,上海 200032
  • 出版日期:2013-12-30 发布日期:2014-02-17
  • 通信作者: 孔琳 E-mail: konglinj@gmail.com

Non-surgical treatment of locoregionally advanced squamous cell carcinoma of the head and neck region

KONG Lin,LU Jia-de   

  1. Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
  • Published:2013-12-30 Online:2014-02-17
  • Contact: KONG Lin E-mail: konglinj@gmail.com

摘要: 局部晚期头颈部鳞癌的治疗往往需要包括手术、放疗、化疗参与的综合治疗,治疗应根据肿瘤原发部位、侵犯范围、患者的身体状况、治疗医生的经验等各项条件而采取个体化的多学科综合治疗。对于可手术切除的头颈部鳞癌,手术±术后放疗(或同期放化疗)仍是其主要的治疗方案,而非手术治疗(放化综合治疗)是另一选择,其目的主要是保留器官和功能。对于不能手术的患者,联合放化疗就成为的唯一选择。近年来发表的TAX323和TAX324研究显示,加用紫杉类、烷化类药物的新型诱导化疗较PF诱导化疗方案,可显著延长患者的生存时间。然而,基于新型诱导化疗的治疗策略同标准的同期联合放化疗相比,是否可进一步提高患者的预后,目前尚无设计良好的临床研究结果支持。本研究将探讨局部晚期头颈部鳞癌非手术治疗策略的临床证据和最新进展。

关键词: 头颈部肿瘤, 放射治疗, 化疗

Abstract: Definitive treatment for locoregionally advanced squamous cell carcinoma of the head and neck region (HNSCC) is challenging, and usually require multidisciplinary efforts involving surgery, radiotherapy, and chemotherapy. Although surgery followed by radiation or chemoradiation therapy remains the standard treatment for resectable disease, combined chemoradiation therapy provides an effective option with organ spearing potential. In addition, combined chemoradiation therapy is the only treatment option for non-metastatic advanced HNSCC. Recently published results from TAX323 and TAX324, two important randomized clinical trials on the efficacy of induction chemotherapy using docetaxel based regimen, showed that induction chemotherapy using TPF can significantly improve patients’ survival as compared to the conventional PF regimen. However, whether TP or TPF induction chemotherapy should be combined with concurrent chemoradiation and considered as part of the standard treatment regimen remains controversial, and requires support from the results of well-designed randomized clinical trial.

Key words: Carcinoma of the head and neck region, Radiotherapy, Chemotherapy