耳鼻咽喉科・頭頸部外科96巻11号

2024年10月発行

特集 頭頸部がん薬物療法—プロに学ぶ最善の選択

《扁平上皮癌に対する薬物療法》

局所進行がんに対する治療：導入化学療法

著者： 横田知哉¹

所属機関： ¹静岡県立静岡がんセンター消化器内科

ページ範囲：P.906 - P.910

文献概要

POINT

●切除可能例に対して，喉頭温存を目的として，放射線療法の前に導入化学療法先行が考慮されるが，化学放射線療法先行との優劣はつけがたい。

●切除不能例に対する遠隔制御，生存向上を目的とした導入化学療法は標準治療として位置づけられていないが，advanced N stageに対しては導入化学療法先行が1つの治療オプションである。

●導入化学療法としての標準レジメンはTPF療法であるが，消化器毒性，電解質異常や骨髄抑制に対する全身管理が必要であり，高齢者，PS低下，腎機能低下などの臓器機能障害や複数の合併症を有する場合には不適である。

●TPFによる導入化学療法の実施が困難と考えられる場合は，PCEによる導入化学療法が考慮される。

参考文献

1）Wolf GT, et al：Induction chemotherapy plus radiation compared with surgery plus radiation in patients with advanced laryngeal cancer. N Engl J Med 324：1685-1690, 1991

2）Lefebvre JL, et al：Laryngeal preservation with induction chemotherapy for hypopharyngeal squamous cell carcinoma：10-year results of EORTC trial 24891. Ann Oncol 23：2708-2714, 2012

3）Lefebvre JL, et al：Larynx preservation in pyriform sinus cancer：preliminary results of a European Organization for Research and Treatment of Cancer phase Ⅲ trial. EORTC Head and Neck Cancer Cooperative Group. J Natl Cancer Inst 88：890-899, 1996

4）Pointreau Y, et al：Randomized trial of induction chemotherapy with cisplatin and 5-fluorouracil with or without docetaxel for larynx preservation. J Natl Cancer Inst 101：498-506, 2009

5）Forastiere AA, et al：Long-term results of RTOG 91-11：a comparison of three nonsurgical treatment strategies to preserve the larynx in patients with locally advanced larynx cancer. J Clin Oncol 31：845-852, 2013

6）Cohen EE, et al：Phase Ⅲ randomized trial of induction chemotherapy in patients with N2 or N3 locally advanced head and neck cancer. J Clin Oncol 32：2735-2743, 2014

7）Haddad R, et al：Induction chemotherapy followed by concurrent chemoradiotherapy（sequential chemoradiotherapy）versus concurrent chemoradiotherapy alone in locally advanced head and neck cancer（PARADIGM）：a randomised phase 3 trial. Lancet Oncol 14：257-264, 2013

8）Budach W, et al：Induction chemotherapy followed by concurrent radio-chemotherapy versus concurrent radio-chemotherapy alone as treatment of locally advanced squamous cell carcinoma of the head and neck（HNSCC）：A meta-analysis of randomized trials. Radiother Oncol 118：238-243, 2016

9）Brockstein B, et al：Patterns of failure, prognostic factors and survival in locoregionally advanced head and neck cancer treated with concomitant chemoradiotherapy：a 9-year, 337-patient, multi-institutional experience. Ann Oncol 15：1179-1186, 2004

10）Izawa N, et al：Efficacy and feasibility of docetaxel, cisplatin, and 5-fluorouracil induction chemotherapy for locally advanced head and neck squamous cell carcinoma classified as clinical nodal stage N2c, N3, or N2b with supraclavicular lymph node metastases. Int J Clin Oncol 20：455-462, 2015

11）Yokota T, et al：Triplet induction chemotherapy followed by less invasive surgery without reconstruction for human papillomavirus-associated oropharyngeal cancers：Why is it successful or unsuccessful? Int J Clin Oncol 26：1039-1048, 2021

12）Park YM, et al：Transoral robotic surgery-based therapy in patients with stage Ⅲ-Ⅳ oropharyngeal squamous cell carcinoma. Oral Oncol 75：16-21, 2017

13）Burke MS, et al：Presurgical induction chemotherapy for squamous cell carcinoma of the tonsil. Laryngoscope 130：1206-1211, 2020

14）Inhestern J, et al：A two-arm multicenter phase Ⅱ trial of one cycle chemoselection split-dose docetaxel, cisplatin and 5-fluorouracil（TPF）induction chemotherapy before two cycles of split TPF followed by curative surgery combined with postoperative radiotherapy in patients with locally advanced oral and oropharyngeal squamous cell cancer（TISOC-1）. Ann Oncol 28：1917-1922, 2017

15）Sadeghi N, et al：Pathologic response to neoadjuvant chemotherapy in HPV-associated oropharynx cancer. Head Neck 42：417-425, 2020

16）Sadeghi N, et al：Neoadjuvant chemotherapy and transoral surgery as a definitive treatment for oropharyngeal cancer：A feasible novel approach. Head Neck 38：1837-1846, 2016

17）Vermorken JB, et al：Cisplatin, fluorouracil, and docetaxel in unresectable head and neck cancer. N Engl J Med 357：1695-1704, 2007

18）Posner MR, et al：Cisplatin and fluorouracil alone or with docetaxel in head and neck cancer. N Engl J Med 357：1705-1715, 2007

19）Blanchard P, et al：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 31：2854-2860, 2013

20）Kies MS, et al：Induction chemotherapy and cetuximab for locally advanced squamous cell carcinoma of the head and neck：results from a phase Ⅱ prospective trial. J Clin Oncol 28：8-14, 2010

21）Wanebo HJ, et al：Induction cetuximab, paclitaxel, and carboplatin followed by chemoradiation with cetuximab, paclitaxel, and carboplatin for stage Ⅲ/Ⅳ head and neck squamous cancer：a phase Ⅱ ECOG-ACRIN trial（E2303）. Ann Oncol 25：2036-2041, 2014

22）Enokida T, et al：A multicenter phase Ⅱ trial of paclitaxel, carboplatin, and cetuximab followed by chemoradiotherapy in patients with unresectable locally advanced squamous cell carcinoma of the head and neck. Cancer Med 9：1671-1682, 2020

23）Shirasu H, et al：Efficacy and feasibility of induction chemotherapy with paclitaxel, carboplatin and cetuximab for locally advanced unresectable head and neck cancer patients ineligible for combination treatment with docetaxel, cisplatin, and 5-fluorouracil. Int J Clin Oncol 25：1914-1920, 2020

24）Hitt R, et al：A randomized phase Ⅲ trial comparing induction chemotherapy followed by chemoradiotherapy versus chemoradiotherapy alone as treatment of unresectable head and neck cancer. Ann Oncol 25：216-225, 2014

25）Lefebvre JL, et al：Induction chemotherapy followed by either chemoradiotherapy or bioradiotherapy for larynx preservation：the TREMPLIN randomized phase Ⅱ study. J Clin Oncol 31：853-859, 2013

26）Hitt R, et al：Randomized phase 3 noninferiority trial of radiotherapy and cisplatin vs radiotherapy and cetuximab after docetaxel-cisplatin-fluorouracil induction chemotherapy in patients with locally advanced unresectable head and neck cancer. Oral Oncol 134：106087, 2022

27）Okano S, et al：Induction TPF chemotherapy followed by CRT with fractionated administration of cisplatin in patients with unresectable locally advanced head and neck cancer. Int J Clin Oncol 24：789-797, 2019

28）Yokota T, et al：Feasibility and efficacy of chemoradiotherapy with concurrent split-dose cisplatin after induction chemotherapy with docetaxel/cisplatin/5-fluorouracil for locally advanced head and neck cancer. Mol Clin Oncol 13：35, 2020