高齢者口腔癌に対する多剤併用動注化学療法 INTRA-ARTERIAL CHEMOTHERAPY WITH SEVERAL ANTICANCER AGENTS FOR ORAL CANCER IN ELDERLY PATIENTS

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著者

    • 鹿野 真人 KANO Makoto
    • 大原綜合病院 頭頸部・顔面外科 Department of Head and Neck, Facial Surgery, Ohara General Hospital
    • 佐藤 栄需 SATOU Eijyu
    • 福島県立医科大学医学部歯科口腔外科 Department of Dentistry and Oral Surgery, Fukushima Medical University School of Medicine
    • 金子 哲治 KANEKO Tetsuharu
    • 福島県立医科大学医学部歯科口腔外科 Department of Dentistry and Oral Surgery, Fukushima Medical University School of Medicine
    • 門馬 勉 MONMA Tsutomu
    • 福島県立医科大学医学部歯科口腔外科 Department of Dentistry and Oral Surgery, Fukushima Medical University School of Medicine
    • 武石 越郎 TAKEISHI Etsuro
    • 福島県立医科大学医学部歯科口腔外科 Department of Dentistry and Oral Surgery, Fukushima Medical University School of Medicine

抄録

高齢者の頭頸部癌治療では副作用が少なく,高い安全性と根治性が要求される。われわれは高齢者口腔癌に対し,ドセタキセル(TXT),シスプラチン(CDDP),ペプロマイシン(PEP),5-FUによるTCPF動注化学療法を行い,その安全性と有効性について検討した。2002年3月から2005年5月までTCPF動注化学療法を行った75歳以上の扁平上皮癌症例10例を対象とした。年齢は75~84歳,平均80歳。部位は舌口腔底8例,頬粘膜1例,上顎歯肉1例。全症例に浅側頭動脈か後頭動脈経由で動注用カテーテルを留置し,TCPF動注化学療法を行い,7例に生検切除を,2例に根治的切除を行った。原発部位に対する効果はCR率80%(8/10),PR率20%(2/10),pathological CR率67%(6/9)であった。副作用は,脳血管障害はなく,動注側の粘膜炎と脱毛が主であり,血液毒性など全身的な副作用はほとんど認めなかった。本療法の有効性と安全性は高く,ハイリスクの高齢者にも根治的治療として適応し得ると考えられた。

In elderly patients with head and neck cancer, a safe and radical treatment with which the incidence of systemic side effects is low is required. We developed a new combination intra-arterial and intra-venous chemotherapy with docetaxel (TXT), cisplatin (CDDP), peplomycin (PEP), and 5-FU (TCPF intra-arterial chemotherapy), and evaluated its usefulness and safety in such patients.<BR>From March 2002 to May 2005, 10 patients aged over 75 years with oral squamous cell carcinoma were treated with TCPF intra-arterial chemotherapy. The patients consisted of 5 males and 5 females aged from 75 to 84 years (median age, 80 years). The tumors were located in the tongue or oral floor in 8 patients, the buccal mucosa in one, and the upper gingiva in one. A catheter for intra-arterial administration was inserted via the superficial temporal artery or occipital artery. Continuous intra-arterial administration of 15 mg/m<SUP>2</SUP> TXT (day 1-5) and 10 mg/body PEP (day 6-10), intra-arterial administration of 7-15 mg/m<SUP>2</SUP> TXT (day 3) and 7-15 mg/m<SUP>2</SUP> CDDP (day 4, 5), and continuous intravenous administration of 250 mg/body/day 5FU (day 1-10) were performed as 1 course. The second course was performed 4 weeks after the completion of the first course in patients for whom it was required. Radiotherapy was additionally performed in one patient. Excision biopsy in 7 patients, and radical excision in 2 were performed after the completion of this treatment.<BR>The effects of this method on the primary lesions were CR 8/10 (80%), PR 2/10 (20%), and pathological CR 6/9 (67%). As side effects, no cerebrovascular disorder was detected, but grades 2-3 mucositis and alopecia on the intra-arterial administration side were observed, without marked systemic disorders. These results indicated that this chemotherapy is useful and safe, and can be applied to as a radical treatment method elderly patients with high risks.

収録刊行物

  • 頭頸部癌/ 日本頭頸部癌学会  

    頭頸部癌/ 日本頭頸部癌学会 32(4), 439-444, 2006-12-25 

    Japan Society for Head and Neck Cancer

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各種コード

  • NII論文ID(NAID)
    10018452688
  • NII書誌ID(NCID)
    AA11985555
  • 本文言語コード
    JPN
  • 資料種別
    ART
  • ISSN
    13495747
  • データ提供元
    CJP書誌  CJP引用  J-STAGE 
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