頭頸部癌に対する放射線とCDDP，THP同時併用療法

Radiotherapy Combined with Small Doses of CDDP and THP for Head and Neck Squamous Cell Carcinomas

　はじめに

　頭頸部領域では扁平上皮癌が多く，この癌腫は放射線感受性が高いので，放射線療法はきわめて重要な治療法となっている。近年，頭頸部扁平上皮癌の治療成績をあげるために，放射線療法に化学療法が併用されるようになってきた。

　併用療法には，通常量の化学療法を放射線治療の前後に併用する方法と，少量の化学療法を同時併用する方法がある。併用化学療法に用いる薬剤の組み合わせや投与法は各施設でいろいろと試みられている。

　Cysplatin （CDDP），Pirarubicin hydrochloride（THP）は単剤でも放射線と同時併用することにより有用な治療効果が得られている^1〜3）。今回，両者の薬剤を頭頸部扁平上皮癌の放射線治療中に同時併用し，治療効果および副作用を検討したので報告する。

From February 1992 through June 1993, 19 cases of head and neck squamous cell carcinomas were treated with radiotherapy combined with adminis-tration of small doses of CDDP and THP. Radiation was administered in a dose of 2 Gy given five times a week combined with CDDP in a dose of 10 mg on day 1 and 3, and THP in a dose of 10 mg on day 5 of each treatment week. Survival was 63 percent at one year and 58 percent at two years. Incidence of the acute complications more severe than grade 2 were myelosuppression 12/19 (63%), stomatitis 11/ 19 (58%), appetite loss 9/19 (47%), and nausea 4/19 (21%). Myelosuppression with grade 3 was occurred in 5 patients and could be treated with granulocyte colony stimulating factor. Stomatitis with grade 3 was occurred in two patients and they needed a nasogastric feeding tube. The result of this combina-tion therapy with radiation, CDDP and THP was good. However, a new treatment regimen should be necessary to avoid severe stomatitis.