Korean Journal of Head & Neck Oncology (대한두경부종양학회지)

The Korean Society for Head and Neck Oncology (대한두경부종양학회)
권호 표지

Concurrent Chemoradiotherapy Using Weekly Cisplatin with or without Daily Oral UFT in Nasopharyngeal Cancer

비인강암에서 저용량 시스플라틴$\pm$경구용 UFT를 이용한 동시항암방사선치료의 효과

  • Ahn Jin-Hee (Department of Medicine, College of Medicine University of Ulsan, Asan Medical Center) ;
  • Chang Hye-Sook (Department of Radiation-Oncology, College of Medicine University of Ulsan, Asan Medical Center) ;
  • Lee Sang-Wook (Department of Radiation-Oncology, College of Medicine University of Ulsan, Asan Medical Center) ;
  • Park Jin-Hong (Department of Radiation-Oncology, College of Medicine University of Ulsan, Asan Medical Center) ;
  • Kim Sang-Yoon (Department of Otorhinolaryngology, College of Medicine University of Ulsan, Asan Medical Center) ;
  • Nam Soon-Yuhl (Department of Otorhinolaryngology, College of Medicine University of Ulsan, Asan Medical Center) ;
  • Cho Kyung-Ja (Department of Diagnostic Pathology, College of Medicine University of Ulsan, Asan Medical Center) ;
  • Kim Woo-Kun (Department of Medicine, College of Medicine University of Ulsan, Asan Medical Center) ;
  • Lee Jung-Shin (Department of Medicine, College of Medicine University of Ulsan, Asan Medical Center) ;
  • Kim Sung-Bae (Department of Medicine, College of Medicine University of Ulsan, Asan Medical Center)
  • 안진희 (울산대학교 의과대학 서울아산병원 종양혈액내과) ;
  • 장혜숙 (울산대학교 의과대학 서울아산병원 방사선종양학과) ;
  • 이상욱 (울산대학교 의과대학 서울아산병원 방사선종양학과) ;
  • 박진홍 (울산대학교 의과대학 서울아산병원 방사선종양학과) ;
  • 김상윤 (울산대학교 의과대학 서울아산병원 이비인후과) ;
  • 남순열 (울산대학교 의과대학 서울아산병원 이비인후과) ;
  • 조경자 (울산대학교 의과대학 서울아산병원 진단병리과) ;
  • 김우건 (울산대학교 의과대학 서울아산병원 종양혈액내과) ;
  • 이정신 (울산대학교 의과대학 서울아산병원 종양혈액내과) ;
  • 김성배 (울산대학교 의과대학 서울아산병원 종양혈액내과)
  • Published : 2002.11.01
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Abstract

연구방법 : 근치적 목적의 동시항암방사선치료를 시행받은 비인강암 환자들을 대상으로하여 치료 효과와 독성에 대한 후향적 분석을 시행하였다. 환자 및 방법 : 1993년 8월부터 1999년 3월까지 원격전이가 없는 50명의 비인강암 환자들이 방사선 치료기간 중 주 1회의 시스플라틴 $20mg/m^2$을 투여받았고, 1999년 4월부터 2000년 4월까지 20명의 환자가 상기 용량의 시스플라틴에 더하여 경구용 UFT300mg을 추가적으로 투여받았다. 총 70명 환자들의 임상기록과 병리 기록지를 검토하였다. 결 과: 연령의 중앙값은 47세 (범위 $18{\sim}76$)였고, 남자와 여자가 각각 53명과 17명 이었으며, 병기 II, III, IVA, IVB가 각각 23명, 14명, 15명, 18명이었다. 치료에 대한 반응율은 92.8%(95% C.I. $42{\sim}143%$)였고(완전반응 57명, 부분반응 8명), 총 34개월의 추적 관찰 기간 동안에 완전반응을 보인 57명 중 21명에서 재발(국소재발 5, 원격전이 11, 복합전이 5)을 하였다. 3년 무진행 생존율은 51.5%였으며 5년 생존율은 60.3%였다. 경구용 UFT의 추가적 사용은 주 1회 시스플라틴 항암치료에 비하여 반응율과 생존율 및 독성에 유의한 영향을 미치지 않았다. 결 론: 주 1회 저용량 시스플라틴$\pm$경구용 UFT를 이용한 동시항암방사선요법은 비인강암 환자의 치료에 있어서 비교적 적은 독성으로 높은 반응율을 나타내었으나, 향후 재발율을 감소시키기 위한 연구가 지속되어야 할 것으로 사료된다.

Keywords

References

  1. Chen WZ, Zhou DL, Luo KS : Long-term observation after radiotherapy for nasopharyngeal carcinoma. Int I Radiat Oncol Biol Phys. 1989 ; 16 : 311-314 https://doi.org/10.1016/0360-3016(89)90320-9
  2. Lee AW, Poon YF, Foo W, et al : Retrospective analysis of 5073 patients with nasopharyngeal carcinoma treated during 1976-1985 : overall survival and patterns of failure. Int J Radiat Oncol Biol Phys. 1992 ; 23 : 261-270 https://doi.org/10.1016/0360-3016(92)90740-9
  3. Zhang EP, Lian PG, Cai KL, et al : Radiation therapy of nasopharyngeal carcinoma : prognostic factors based on a 10 year follow-up of 1302 patients. Int J Radiat Oncol Biol Phys. 1989 ; 16 : 301-305 https://doi.org/10.1016/0360-3016(89)90318-0
  4. Rossi A, Molinari R, Boracchi P, et al : Adjuvant chemotherapy with vincritstine, cyclophosphamide, and doxorubicin after radiotherapy in loco-regional nasopharyngeal cancer : Results of a 4-year multicenter randomized study. J Clin Oncol. 1988 ; 6 : 1401-1410 https://doi.org/10.1200/JCO.1988.6.9.1401
  5. Chan AT, Teo PM, Leung TW, et al : A prospective randomized study of chemotherapy adjunctive to definitive radiotherapy in advanced nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 1995 ; 33 : 569-577 https://doi.org/10.1016/0360-3016(95)00218-N
  6. Ma J, Mai HQ, Hong MH, et al : Results of a prospective randomized trial comparing neoadjuvant chemotherapy plus radiotherapy with radiotherapy alone in patients with locoregionally advanced nasopharyngeal carcinoma. J Clin Oncol. 2001 ; 19 : 1350-1357 https://doi.org/10.1200/JCO.2001.19.5.1350
  7. Bourhis J, Eschwege F : Radiotherapy-chemotherapy combinations in head and neck squamous cell carcinoma : Overview of randomized trials. Anticancer Res. 1996 ; 16 : 2397-2402
  8. Munro AJ : An overview of randomized controlled trials of adjuvant chemotherapy in head and neck cancer. Br J Cancer. 1995 ; 71 : 83-91 https://doi.org/10.1038/bjc.1995.17
  9. Pignon JP, Bourhis J, Domenge C, Designe L : Chemotherapy added to locoregional treatment for head and neck squamous cell carcinoma : three meta- analyses of updated individual data. Loncet. 2000 ; 355 : 949-955 https://doi.org/10.1016/S0140-6736(00)90011-4
  10. Al-Sarraf M, LeBlanc M, Fu K, et al : Chemoradiotherapy versus radiotherapy in patients with advanced nasopharyngeal cancer : phase III randomized intergroup study 0099. J Clin Oncol. 1998 ; 16 : 1310-1307 https://doi.org/10.1200/JCO.1998.16.4.1310
  11. Jeremic B, Shibamoto Y, Milicic B, et al : Hyperfractionated radiation therapy with or without concurrent low-dose daily cisplatin in locally advanced squamous cell carcinoma of the head and neck : A prospective randomized trial. J Clin Oncol. 2000 ; 18 : 1458-1464 https://doi.org/10.1200/JCO.2000.18.7.1458
  12. Haselow RE, Warshaw MG, Oken MM et al : Radiation alone versus radiation plus weekly low-dose cisplatinum in unresectable cancer of the head and neck. In : Fee WE Jr, Goepfert H, Johns ME et al, editor. Head and Neck Cancer; Toronto : BC Decker; 1990 : 279-281
  13. Bachaud JM, Cohen-Jonathan E, Alzieu C, et al : Combined postoperative radiotherapy and weekly cisplatin infusion for locally advanced head and neck carcinioma : final report of a randomized trial. Int J Radiat Oncol Biol Phys. 1996 ; 36 : 999-1004 https://doi.org/10.1016/S0360-3016(96)00430-0
  14. Kokubo M, Nagata Y, Nishimura Y, et al : Concurrent chemoradiotherapy for oropharyngeal carcinoma. Am J Clin Oncol. 2001 ; 24 : 71-76 https://doi.org/10.1097/00000421-200102000-00013
  15. Amrein P, Barton J, Benner S, et al : A phase II study of oral uracil and ftorafur (UFT) plus leucovorin in advanced local-regional or metastatic squamous cell carcinoma of the head and neck. Proc Am Soc Clin Oncol. 2000 ; 19 : abstract 1661
  16. Ho DH, Pazdur R, Covington W, et al : Comparison of 5-fluo-rouracil pharmacokinetics in patients receiving continuous infusion and oral uracil plus N1-(2'-tetrahydrofuryl)-5-fluorouracil. Clin Cancer Res. 1998 ; 4 : 2085-2088
  17. Miller AB, Hoogstraten B, Staquet M : Reporting results of cancer treatment. Cancer. 1981 ; 47 : 207-214 https://doi.org/10.1002/1097-0142(19810101)47:1<207::AID-CNCR2820470134>3.0.CO;2-6
  18. Fleming ID, Cooper JS, Henson DE(eds) : AJCC cancer staging manual 5th edition. New York: Lippincott-Raven; 1997
  19. Lin JC, Jan JS : Locally advanced nasopharyngeal cancer: Long-term outcomes of radiation therapy. Radiat Oncol. 1999 ; 211 : 513-518
  20. Teo PM, Chan AT, Lee WY, Leung TW, Johnson PJ : Enhancement of local control in locally advanced node-positive naso-pharyngeal carcinoma by adjunctive chemotherapy. Int J Radiat Oncol Biol Phys. 1999 ; 43 : 261-271 https://doi.org/10.1016/S0360-3016(98)00383-6
  21. Fu KK, Phillips TL : Biologic rationale of combined radiotherapy and chemotherapy. Hematol Oncol Clin North. Am. 1991 ; 5 : 725-736
  22. Byfield JE, Calabro-Jones P, Klisak I, Kulhanian F : Pharmacologic requirements for obtaining sensitization of human tumor cells in vitro to combined 5-fluorouracil or florafur and x-ray. Int J Radiat Oncol Biol Phys. 1982 ; 8 : 1923-1933 https://doi.org/10.1016/0360-3016(82)90451-5
  23. Kyriazis AP, Yagoda A, Kereiakes JG, Kyriazis AA, Whitmore WF : Experimental studies on the radiation-modifying effect of cis-diamminedichloroplatinum II (DDP) in human bladder transitional cell carcinomas grown in nude mice. Cancer. 1983 ; 52 : 452-457 https://doi.org/10.1002/1097-0142(19830801)52:3<452::AID-CNCR2820520312>3.0.CO;2-P
  24. Forastiere AA, Belliveau JF, Goren MP, et al : Pharmacokinetic and toxicity evaluation of five-day continuous infusion versus intermittent bolus cisdiamminedichloroplatinum(II) in head and neck cancer patients. Cancer Res. 1988;48:3869-3874.
  25. Chan AT, Teo PM, Johnson PJ : Controversies in the management of locoregionally advanced nasopharyngeal carcinioma. Curr Opin Oncol. 1998 ; 10 : 219-225 https://doi.org/10.1097/00001622-199805000-00008
  26. Chan A, Chan D, Cheung F, et al : A phase III randomized comparing concurrent chemotherapy-radiotherpay with radiotherapy alone in locoregionally advanced nasopharyngeal carcinoma. Proc Am Soc Clin Oncol. 2000 ; 19 : abstract 1637
  27. Gonzalez-Larriba JL, Garcia Carbonero I, Sastre Valera J, Perez Segura P, Diaz-Rubio E : Neoadjuvant therapy with cisplatin/fluorouracil vs cisplatin/UliT in locally advanced squamous cell head and neck cancer. Oncology. 1997 ; 11 (9 Suppl 10) : 90-97
  28. Alfonsi M, Bardet E, Bergerot C, et al : Randomized study comparing radiation alone (RT) versus RT with concomitant chemotherapy in stage III and IV oropharynx carcinoma : Preliminary results of the 94.01 study from the French Group of Radiation Oncology for Head and Neck Cancer. Proc Am Soc Clin Oncol. 1998 ; 17 : abstract 1484
  29. Wendt TG, Grabenhauer GG, Rodel CM, et al : A. Simultaneous radiochemotherapy versus radiotherapy alone in advanced head and neck cancer : A randomized multicenter study. J Clin Oncol. 1998 ; 16 : 1318-1324