- 著者
-
野々下 豪
塩山 善之
國武 直信
Nakamura Katsumasa
Nomoto Satoshi
Ohga Saiji
Toriya Youichi
Ono Minoru
Honda Hiroshi
- 出版者
- 福岡医学会
- 雑誌
- 福岡医学雑誌 (ISSN:0016254X)
- 巻号頁・発行日
- vol.100, no.1, pp.26-31, 2009-01-25
This study aimed to evaluate the efficacy and toxicity of concurrent chemoradiotherapy and adjuvant chemotherapy for T2N0 glottic squamous cell carcinoma. Between May 1993 and March 2004, 32 patients with T2N0 glottic squamous cell carcinoma received concurrent chemoradiotherapy as the primary treatment modality for larynx preservation. Radiotherapy was delivered five days a week using a once-daily fractionation of 2.0 Gy (median total dose: 70 Gy). The chemotherapy regimen comprised carboplatin in 4 patients, carboplatin and tegafur and uracil in 7, carboplatin and futraful in 2, and futraful in 19 patients. Twenty-four patients received adjuvant chemotherapy with tegafur and uracil. Initial local tumor control was achieved in 30 patients (94%). The 5-year overall survival and 5-year local control rates were 97% and 70%, respectively. Univariate analysis revealed adjuvant chemotherapy as a significant prognostic factor for the local control rate (P = 0.038). The 5-year local control rate in patients treated or not treated with adjuvant chemotherapy was 82% and 42%, respectively. No significant differences in the local control rate were noted in overall treatment time, total radiation dose, age, and disease extension to the subglottis. With regard to adverse reactions, grade 3 neutropenia and grade 3 hepatotoxicity were observed in 1 and 2 patients, respectively. We observed no severe late complications (RTOG/EORTC criteria Grade 3-4) related to this combination therapy. Concurrent chemoradiotherapy and adjuvant chemotherapy was effective but with mild toxicity, and adjuvant chemotherapy significantly improved local control. We suggest the use of this combination therapy for achieving a local control of T2N0 glottic squamous cell carcinoma.目的:T2N0声門癌に対する化学放射線療法,補助化学療法の効果,有害事象の遡及的検討.対象・方法:1993年5月から2004年3月に喉頭温存を目的に初回治療として化学放射線療法を施行されたT2N0声門癌の32例.放射線治療は1日1回,1回2Gy,週5回施行され,総線量の中央値は70Gy.化学療法はカルボプラチン単独が4例,カルボプラチンとUFT の併用が7例,カルボプラチンとフトラフールの併用が2例,フトラフール単独が19 例.化学放射線療法終了後24 例にUFTによる補助化学療法を施行.結果:一次治療効果でCRであったのは30例(94%).5年粗生存率,5年局所制御率はそれぞれ97%,70%.局所制御に関する単変量解析では,補助化学療法の施行により有意な改善を認めた(P=0.038).5年局所制御率は補助化学療法の有無でそれぞれ,82%,42%.総治療期間,総線量,年齢,病変の声門下への進展の有無では有意差は認めなかった.有害事象に関してはgrade3 の好中球減少を1例,grade3の肝機能障害を2例に認めた.重篤な晩期有害事象は認めなかった.結論:T2N0 声門癌に対する補助化学療法は局所制御に関して統計学的に有意な改善が認められ,また有害事象は軽度であり,有用性が示唆された.