Baidu
map

肿瘤科

订阅

MedSci主页 / 所有栏目 / 肿瘤科

JCO：Tax-PF诱导化疗治疗局部晚期头颈癌结局较好

2013-07-25 JCO dxy

头颈癌Tax-PFJCO随机试验
关注

部分针对局部晚期头颈癌(LAHNC)进行的随机试验曾对顺铂-氟尿嘧啶(PF)诱导化疗方案与紫杉类(多西他赛或紫杉醇)、顺铂及氟尿嘧啶(Tax-PF)方案进行过比较。在2013年7月8日在线出版的《临床肿瘤学杂志》(Journal of Clinical Oncology)上，法国古斯塔夫·鲁西研究所Jean-Pierre Pignon博士等人对相关研究进行了一项荟萃分析，该分析对Tax-PF与PF

部分针对局部晚期头颈癌(LAHNC)进行的随机试验曾对顺铂-氟尿嘧啶(PF)诱导化疗方案与紫杉类(多西他赛或紫杉醇)、顺铂及氟尿嘧啶(Tax-PF)方案进行过比较。在2013年7月8日在线出版的《临床肿瘤学杂志》(Journal of Clinical Oncology)上，法国古斯塔夫·鲁西研究所Jean-Pierre Pignon博士等人对相关研究进行了一项荟萃分析，该分析对Tax-PF与PF方案的药效与毒性进行了考察，并对不同患者亚群的结局差异进行了鉴定。

该分析共甄别出5项随机试验中的1,772例患者。同时对所有试验中的患者最新数据(IPD)进行了检索。按试验进行分层后，利用对数秩检验法进行比较。此外，通过互作效应或趋势检验对协变量及治疗间的相互作用进行研究。

结果显示，相关研究的中位随访时间为4.9年。患者死亡风险比(HR)为0.79 ，Tax-PF结果较好。异质性较为显著，并与一项试验有关。将该试验筛除后，不再存在异质性，最终死亡HR为0.72 ，Tax-PF结果较好。治疗效果与以下患者协变量间并无互作效应：年龄、性别、功能状态、肿瘤分期或部位。Tax-PF与进展程度、局部失败及远端失败的明显降低间存在显著关联，HR分别为0.78 、0.79 及 0.63 。

该项IPD荟萃分析表明，Tax-PF诱导化疗方案优于PF方案。但该方案在LSHNC控制中的准确作用仍需进一步确定。

背景介绍：尽管筛查手段已经取得了部分进展，同时流行病学趋势也出现了变化，但在确诊时，头颈部鳞状细胞癌(HNSCC)患者仍多处于局部晚期阶段。作为一种常规治疗手段，现已证明同步放化疗(CRT)可改善患者生存。针对头颈癌化疗(MACH-NC)的荟萃研究显示，通过顺铂-氟尿嘧啶(PF)诱导化疗进行的局部治疗并未降低局部失败率。不仅如此，该方案与较小的总生存率及远端失败率改善有关。MACH-NC数据库中，一项生存率探索性间接分析表明，CRT优于PF诱导化疗。因此除了保喉治疗外(PF诱导化疗和同步CRT均可作为常规治疗手段)，并不将PF作为局部晚期HNSCC的常规治疗手段。

在近期的随机试验中，曾针对紫杉类、顺铂及氟尿嘧啶(Tax-PF)诱导治疗方案是否优于PF方案进行了研究。多少研究证明，Tax-PF组患者OS及无进展生存率(PFS)均取得显著增加，但因研究能力所限，未能针对更具体终点展开研究。

因此，MACH-NC协作组于2008年启动了包括所有紫杉类药物临床试验在内的MACH-NC数据库更新，从中可对生存、失败类型、毒性及治疗效果与患者亚群间的互作效应等终点的相关结果进行归纳。


Blanchard P, Bourhis J, Lacas B, Posner MR, Vermorken JB, Cruz Hernandez JJ, Bourredjem A, Calais G, Paccagnella A, Hitt R, Pignon JP;Taxane-Cisplatin-Fluorouracil As Induction Chemotherapy in Locally Advanced Head and Neck Cancers: An Individual Patient Data Meta-Analysis of the Meta-Analysis of Chemotherapy in Head and Neck Cancer Group.J Clin Oncol. 2013 Jul 8.

版权声明：
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料，版权均属于梅斯医学所有。非经授权，任何媒体、网站或个人不得转载，授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章，或“梅斯号”自媒体发布的文章，仅系出于传递更多信息之目的，本站仅负责审核内容合规，其内容不代表本站立场，本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系，我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1891077, encodeId=2c9e18910e7a4, content=<a href='/topic/show?id=25b0102e2df' target=_blank style='color:#2F92EE;'>#JCO#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10272, encryptionId=25b0102e2df, topicName=JCO)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6da1120, createdName=lidong40, createdTime=Thu Jun 19 23:24:00 CST 2014, time=2014-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1650700, encodeId=8e231650e009c, content=<a href='/topic/show?id=ffae4e614b6' target=_blank style='color:#2F92EE;'>#局部晚期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47614, encryptionId=ffae4e614b6, topicName=局部晚期)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=901d24099859, createdName=yhy100208, createdTime=Sun Jun 15 19:24:00 CST 2014, time=2014-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1295859, encodeId=83ff1295859ee, content=<a href='/topic/show?id=f30a4441598' target=_blank style='color:#2F92EE;'>#头颈癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44415, encryptionId=f30a4441598, topicName=头颈癌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6c32257, createdName=DEXTER3139, createdTime=Sat Jul 27 06:24:00 CST 2013, time=2013-07-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1405644, encodeId=9ae9140564450, content=<a href='/topic/show?id=a5404e589d7' target=_blank style='color:#2F92EE;'>#局部#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47589, encryptionId=a5404e589d7, topicName=局部)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d14c2562456, createdName=chg122, createdTime=Sat Jul 27 06:24:00 CST 2013, time=2013-07-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1555651, encodeId=50d51555651be, content=<a href='/topic/show?id=fe2f918e29b' target=_blank style='color:#2F92EE;'>#诱导化疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=91872, encryptionId=fe2f918e29b, topicName=诱导化疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=xinxin088, createdTime=Sat Jul 27 06:24:00 CST 2013, time=2013-07-27, status=1, ipAttribution=)]
    2014-06-19 lidong40

    #JCO#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1891077, encodeId=2c9e18910e7a4, content=<a href='/topic/show?id=25b0102e2df' target=_blank style='color:#2F92EE;'>#JCO#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10272, encryptionId=25b0102e2df, topicName=JCO)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6da1120, createdName=lidong40, createdTime=Thu Jun 19 23:24:00 CST 2014, time=2014-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1650700, encodeId=8e231650e009c, content=<a href='/topic/show?id=ffae4e614b6' target=_blank style='color:#2F92EE;'>#局部晚期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47614, encryptionId=ffae4e614b6, topicName=局部晚期)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=901d24099859, createdName=yhy100208, createdTime=Sun Jun 15 19:24:00 CST 2014, time=2014-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1295859, encodeId=83ff1295859ee, content=<a href='/topic/show?id=f30a4441598' target=_blank style='color:#2F92EE;'>#头颈癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44415, encryptionId=f30a4441598, topicName=头颈癌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6c32257, createdName=DEXTER3139, createdTime=Sat Jul 27 06:24:00 CST 2013, time=2013-07-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1405644, encodeId=9ae9140564450, content=<a href='/topic/show?id=a5404e589d7' target=_blank style='color:#2F92EE;'>#局部#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47589, encryptionId=a5404e589d7, topicName=局部)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d14c2562456, createdName=chg122, createdTime=Sat Jul 27 06:24:00 CST 2013, time=2013-07-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1555651, encodeId=50d51555651be, content=<a href='/topic/show?id=fe2f918e29b' target=_blank style='color:#2F92EE;'>#诱导化疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=91872, encryptionId=fe2f918e29b, topicName=诱导化疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=xinxin088, createdTime=Sat Jul 27 06:24:00 CST 2013, time=2013-07-27, status=1, ipAttribution=)]
    2014-06-15 yhy100208

    #局部晚期#

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1891077, encodeId=2c9e18910e7a4, content=<a href='/topic/show?id=25b0102e2df' target=_blank style='color:#2F92EE;'>#JCO#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10272, encryptionId=25b0102e2df, topicName=JCO)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6da1120, createdName=lidong40, createdTime=Thu Jun 19 23:24:00 CST 2014, time=2014-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1650700, encodeId=8e231650e009c, content=<a href='/topic/show?id=ffae4e614b6' target=_blank style='color:#2F92EE;'>#局部晚期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47614, encryptionId=ffae4e614b6, topicName=局部晚期)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=901d24099859, createdName=yhy100208, createdTime=Sun Jun 15 19:24:00 CST 2014, time=2014-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1295859, encodeId=83ff1295859ee, content=<a href='/topic/show?id=f30a4441598' target=_blank style='color:#2F92EE;'>#头颈癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44415, encryptionId=f30a4441598, topicName=头颈癌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6c32257, createdName=DEXTER3139, createdTime=Sat Jul 27 06:24:00 CST 2013, time=2013-07-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1405644, encodeId=9ae9140564450, content=<a href='/topic/show?id=a5404e589d7' target=_blank style='color:#2F92EE;'>#局部#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47589, encryptionId=a5404e589d7, topicName=局部)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d14c2562456, createdName=chg122, createdTime=Sat Jul 27 06:24:00 CST 2013, time=2013-07-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1555651, encodeId=50d51555651be, content=<a href='/topic/show?id=fe2f918e29b' target=_blank style='color:#2F92EE;'>#诱导化疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=91872, encryptionId=fe2f918e29b, topicName=诱导化疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=xinxin088, createdTime=Sat Jul 27 06:24:00 CST 2013, time=2013-07-27, status=1, ipAttribution=)]
    2013-07-27 DEXTER3139

    #头颈癌#

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1891077, encodeId=2c9e18910e7a4, content=<a href='/topic/show?id=25b0102e2df' target=_blank style='color:#2F92EE;'>#JCO#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10272, encryptionId=25b0102e2df, topicName=JCO)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6da1120, createdName=lidong40, createdTime=Thu Jun 19 23:24:00 CST 2014, time=2014-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1650700, encodeId=8e231650e009c, content=<a href='/topic/show?id=ffae4e614b6' target=_blank style='color:#2F92EE;'>#局部晚期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47614, encryptionId=ffae4e614b6, topicName=局部晚期)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=901d24099859, createdName=yhy100208, createdTime=Sun Jun 15 19:24:00 CST 2014, time=2014-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1295859, encodeId=83ff1295859ee, content=<a href='/topic/show?id=f30a4441598' target=_blank style='color:#2F92EE;'>#头颈癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44415, encryptionId=f30a4441598, topicName=头颈癌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6c32257, createdName=DEXTER3139, createdTime=Sat Jul 27 06:24:00 CST 2013, time=2013-07-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1405644, encodeId=9ae9140564450, content=<a href='/topic/show?id=a5404e589d7' target=_blank style='color:#2F92EE;'>#局部#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47589, encryptionId=a5404e589d7, topicName=局部)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d14c2562456, createdName=chg122, createdTime=Sat Jul 27 06:24:00 CST 2013, time=2013-07-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1555651, encodeId=50d51555651be, content=<a href='/topic/show?id=fe2f918e29b' target=_blank style='color:#2F92EE;'>#诱导化疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=91872, encryptionId=fe2f918e29b, topicName=诱导化疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=xinxin088, createdTime=Sat Jul 27 06:24:00 CST 2013, time=2013-07-27, status=1, ipAttribution=)]
    2013-07-27 chg122

    #局部#

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1891077, encodeId=2c9e18910e7a4, content=<a href='/topic/show?id=25b0102e2df' target=_blank style='color:#2F92EE;'>#JCO#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10272, encryptionId=25b0102e2df, topicName=JCO)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6da1120, createdName=lidong40, createdTime=Thu Jun 19 23:24:00 CST 2014, time=2014-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1650700, encodeId=8e231650e009c, content=<a href='/topic/show?id=ffae4e614b6' target=_blank style='color:#2F92EE;'>#局部晚期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47614, encryptionId=ffae4e614b6, topicName=局部晚期)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=901d24099859, createdName=yhy100208, createdTime=Sun Jun 15 19:24:00 CST 2014, time=2014-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1295859, encodeId=83ff1295859ee, content=<a href='/topic/show?id=f30a4441598' target=_blank style='color:#2F92EE;'>#头颈癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44415, encryptionId=f30a4441598, topicName=头颈癌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6c32257, createdName=DEXTER3139, createdTime=Sat Jul 27 06:24:00 CST 2013, time=2013-07-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1405644, encodeId=9ae9140564450, content=<a href='/topic/show?id=a5404e589d7' target=_blank style='color:#2F92EE;'>#局部#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47589, encryptionId=a5404e589d7, topicName=局部)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d14c2562456, createdName=chg122, createdTime=Sat Jul 27 06:24:00 CST 2013, time=2013-07-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1555651, encodeId=50d51555651be, content=<a href='/topic/show?id=fe2f918e29b' target=_blank style='color:#2F92EE;'>#诱导化疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=91872, encryptionId=fe2f918e29b, topicName=诱导化疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=xinxin088, createdTime=Sat Jul 27 06:24:00 CST 2013, time=2013-07-27, status=1, ipAttribution=)]
    2013-07-27 xinxin088

    #诱导化疗#

    0

相关资讯

多塞平可缓解头颈癌患者口腔痛

  　　最近一项研究发现，对于接受放疗的头颈癌患者，抗抑郁药多塞平可减轻其口腔粘膜的炎症引起的相关疼痛。 　　“口腔粘膜炎或口腔溃疡是一种放疗相关副作用，引起患者疼痛。”研究主要负责者、梅奥诊所放射肿瘤学家也是罗伯特?米勒说，“我们的发现为这种情况的治疗提供了新的应对标准。” 　　该项三期临床试验共纳入155例接受放疗的头颈癌患者，随机分为多塞平口腔灌洗组和安慰剂组，并对疗效进行评

Baidu
map
Baidu
map
Baidu
map