頭頚部へん平上皮癌患者を対象としたシスプラチンまたはカルボプラチンとペプロマイシンの動注に放射線治療を組み合わせた術前治療の評価

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For evaluation of neo-adjuvant chemotherapy with intraarterial administration of cisplatin (CDDP) plus peplomycin (PEP) or carboplatin (CBDCA) plus PEP, effects of preoperative treatment on the histological findings of resected tumors and prognosis between the patients treated with the above neo-adjuvant chemo-and radio-therapy (NCRT group) and those treated with only radiotherapy (RT group) were compared in previously untreated patients with head and neck squamous cell carcinoma. The NCRT group is consisted of 28 patients, who received intraarterial administration of CDDP 20mg/m2 or CBDCA 80-100 mg/m2 on day 1 and 8, and PEP 5mg/day with daily 2 Gy irradiation from day 1 to 5 and from day 8 to 12 preoperatively. The RT group consists of 27 patients, who received preoperative radiotherapy with γ or electron beam.Sex, age, T-, N- and Stage-classification, and tumor cell differentiation showed no significant difference between the two groups, while total radiation dose of the RT group was significantly more than that of the NCRT group. Three-year-survival rate with Kaplan-Meier's method was significantly higher in the NCRT group than in the RT group. Recurrence rate (in primary lesions, cervical lymph nodes, or distant organs) was significantly lower in the NCRT group than in the RT group. Though the histological findings of the resected materials showed slightly greater effect in the NCRT group than in the RT group, there was no significant correlation between the effect and tumor recurrence rate.From the above findings it was suggested that better prognosis was realized in the NCRT group partly because of relatively great effects on the histological findings by the preoperative treatments in a short period and partly because of supression of local micrometastasis of tumor cells.