Skuamöz hücreli baş boyun kanserinde kemoradyoterapi
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Date
2011-03-01
Authors
Özşahin, Esat Mahmut
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Skuamöz hücreli baş boyun kanserinin (SHBBK) tedavisi multisipliner yaklaşımı gerektirmektedir. Erken evre SHBBK’de postoperatif yüksek risk faktörü olan olgularda adjuvan KRT altın standarttır. Lokal ileri evre SHBBK’de ise tedavi; cerrahi ve adjuvan kemoradyoterapi (KRT), indüksiyon kemoterapi (KT) sonrası definitif KRT ya da sadece KRT’yi içermektedir. Özellikle operabıl SHBBK’de indüksiyon kemoterapi sonrası KRT, organ koruma için başarılı bir tedavi yaklaşımıdır. Birçok çalışmada KRT sadece radyoterapiye (RT) göre belirgin sağkalım avantajıyla beraber olduğu gösterilmiştir. Özellikle organ koruyucu tedavide, tedavi etkinliğini artırmak için taksanlarla beraber yeni indüksiyon KT kombinasyonları araştırılmış ve sonuçlar sisplatin-5-flourasil tedavisine göre daha etkili bulunmuştur. RT ile eş zamanlı taksan kullanımının etkinliği ise sadece Faz II çalışmalarda gösterilmiştir. Son dönemde yapılan çalışmalarda, epidermal büyüme faktör reseptör inhibitörü (Setuksimab) ile RT kombinasyonunun sağkalım üzerinde olumlu etkinliği saptanmıştır. Bu derlemede, klinik çalışmalar zemininde güncel literatürleri inceleyerek, yeni ajanların gelecekteki rolünü gözden geçirdik.
The treatment of head and neck squmaous cell cancer (HNSSC) requires a multidisciplinary management. Postoperative chemoradiotherapy (CRT) has been the gold standart in the patients with early stage HNSSC with poor prognostic factors. The treatment of locally advanced HNSSC includes surgery and adjuvant CRT, induction chemotherapy followed by definitive CRT or CRT alone. Induction chemotherapy followed by definitive CRT has been a successful approach for organ preservation, in particularly operable HNSSC. It has been demonstrated that the greatest survival benefit over radiotherapy (RT) alone is seen with the CRT in several trials. Specifically, to improve the efficacy of the treatment for organ preservation, it has been explored new induction combination regimens with taxanes and found to be more efficient comparing with the cisplatin-5 fluorouracil regimens. The favorable efficiency of the concomitantly usage of taxans with RT, has been demonstrated in only Phase II studies. More recently, the improving efficacy of epidermal growth factor receptor inhibitor (Cetuximab) combined with RT has been determined on survival in several trials. In this review, we overviewed the current literatures within the future role of new agents on the base of clinical trials.
The treatment of head and neck squmaous cell cancer (HNSSC) requires a multidisciplinary management. Postoperative chemoradiotherapy (CRT) has been the gold standart in the patients with early stage HNSSC with poor prognostic factors. The treatment of locally advanced HNSSC includes surgery and adjuvant CRT, induction chemotherapy followed by definitive CRT or CRT alone. Induction chemotherapy followed by definitive CRT has been a successful approach for organ preservation, in particularly operable HNSSC. It has been demonstrated that the greatest survival benefit over radiotherapy (RT) alone is seen with the CRT in several trials. Specifically, to improve the efficacy of the treatment for organ preservation, it has been explored new induction combination regimens with taxanes and found to be more efficient comparing with the cisplatin-5 fluorouracil regimens. The favorable efficiency of the concomitantly usage of taxans with RT, has been demonstrated in only Phase II studies. More recently, the improving efficacy of epidermal growth factor receptor inhibitor (Cetuximab) combined with RT has been determined on survival in several trials. In this review, we overviewed the current literatures within the future role of new agents on the base of clinical trials.
Description
Keywords
Baş boyun kanseri, Kemoradyoterapi, Head and neck cancer, Sağkalım, Survival, Chemoradiotherapy
Citation
Demiröz, C. ve Özşahin, E. M. (2011). ''Skuamöz hücreli baş boyun kanserinde kemoradyoterapi''. Uludağ Üniversitesi Tıp Fakültesi Dergisi, 37(1), 61-65.