Head and Neck TumorsHead and Neck TumorsОпухоли головы и шеи2222-14682411-4634Publishing House ABV Press61010.17650/2222-1468-2021-11-1-41-50DIAGNOSIS AND TREATMENT OF HEAD AND NECK TUMORSДИАГНОСТИКА И ЛЕЧЕНИЕ ОПУХОЛЕЙ ГОЛОВЫ И ШЕИResults of conservative treatment of locally advanced larynx squamous cell carcinoma using intraarterial regional polychemotherapyРезультаты консервативного лечения местно-распространенного плоскоклеточного рака гортани с применением внутриартериальной регионарной полихимиотерапииhttps://orcid.org/0000-0003-2793-5597SafarovD. A.СафаровД. А.
Russian Federation

David Afatdinovich Safarov

24 Kashirskoe Sh., Moscow 115478

Давид Афатдинович Сафаров

115478 Москва, Каширское шоссе, 24

SafarowD@mail.ruhttps://orcid.org/0000-0003-1255-5700MudunovA. M.МудуновА. М.
Russian Federation

1111st Uspenskoe Sh., Lapino 143081, Odintsovo city district, Moscow region

Московская область, Одинцовский городской округ, 143081 д. Лапино, 1-е Успенское шоссе, 111

https://orcid.org/0000-0001-7185-7165DolgushinB. I.ДолгушинБ. И.
Russian Federation

24 Kashirskoe Sh., Moscow 115478

115478 Москва, Каширское шоссе, 24

https://orcid.org/0000-0002-9543-990XAkhundovA. A.АхундовА. А.
Russian Federation

24 Kashirskoe Sh., Moscow 115478

115478 Москва, Каширское шоссе, 24

https://orcid.org/0000-0003-0183-4827ZaderenkoI. A.ЗадеренкоИ. А.
Russian Federation

24 Kashirskoe Sh., Moscow 115478

115478 Москва, Каширское шоссе, 24

https://orcid.org/0000-0003-1611-4603PeshkoD. A.ПешкоД. А.
Russian Federation

24 Kashirskoe Sh., Moscow 115478

115478 Москва, Каширское шоссе, 24

N.N. Blokhin National Medical Research Center of Oncology of the Ministry of Health of RussiaФГБУ Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина Минздрава РоссииLapino Clinical HospitalКлинический госпиталь Лапино2404202111141502304202123042021Copyright ©; 2021, Safarov D.A., Mudunov A.M., Dolgushin B.I., Akhundov A.A., Zaderenko I.A., Peshko D.A.Copyright ©; 2021, Сафаров Д.А., Мудунов А.М., Долгушин Б.И., Ахундов А.А., Задеренко И.А., Пешко Д.А.2021Safarov D.A., Mudunov A.M., Dolgushin B.I., Akhundov A.A., Zaderenko I.A., Peshko D.A.Сафаров Д.А., Мудунов А.М., Долгушин Б.И., Ахундов А.А., Задеренко И.А., Пешко Д.А.https://creativecommons.org/licenses/by/4.0https://ogsh.abvpress.ru/jour/article/view/610

The study objective is to evaluate the results of organ-preserving treatment of locally advanced larynx squamous cell carcinoma.

Materials and methods. Analysis of 28 patients with locally advanced larynx squamous cell carcinoma (stages III-IV) who underwent treatment at the N.N. Blokhin National Medical Research Center of Oncology of the Ministry of Health of Russia between 2017 and 2020 was performed. At the first stage, 2-3 courses of combined inductive polychemotherapy per the DCF scheme with 21-day interval were performed (docetaxel 60 mg/m2, cisplatin 60 mg/m2 intraarterially bolus with detoxication with sodium thiosulfate, 5-fluorouracil 1000 mg/m2/day as 96-hour infusion). The second stage included external beam radiotherapy (60-70 Gy, 2 Gy per day 5 days a week) as monotreatment if complete clinical response after chemotherapy was achieved or with regional administration of cisplatin (60 mg/m2 once per 3 weeks) if after inductive stage full clinical response wasn»t observed.

Results. In 20 (71.5 %) patients, complete clinical response was observed after inductive treatment; in 7 (25 %) patients, partial response was observed. Tumor stabilization was detected in 1 (3.5 %) patient. Two-year overall survival was 95.8 ± 4.1 %, progression-free survival was 90.1 ± 6.8 %.

Conclusion. The proposed strategy of organ-preserving treatment of stage III-IV larynx cancer with substitution of systemic chemotherapy with regional intraarterial chemotherapy prior to radiotherapy is highly effective from the point of view of direct anti-tumor effect and recurrence-free and overall survival.

Цель исследования. Оценить результаты органосохраняющего лечения местно-распространенного плоскоклеточного рака гортани.

Материалы и методы. Проведен анализ данных 28 больных местно-распространенным плоскоклеточным раком гортани (III-IV стадии), получавших лечение в ФГБУ «Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина» Минздрава России с 2017 по 2020 г. На 1-м этапе проводились 2-3 курса комбинированной индукционной полихимиотерапии по схеме DCF с интервалом в 21 день (доцетаксел 60 мг/м2, цисплатин 60 мг/м2 внутриартерально болюсно на фоне детоксикации тиосульфатом натрия, 5-фто-рурацил 1000 мг/м2/сут в виде 96-часовой внутривенной инфузии). На 2-м этапе проведен курс дистанционной лучевой терапии (60-70 Гр, 2 Гр в сутки 5 раз в неделю) в монорежиме в случае достижения полного клинического ответа после химиотерапии либо на фоне регионарного введения цисплатина (60 мг/м2 1 раз в 3 нед) в тех случаях, когда после индукционного этапа лечения не достигнут полный клинический ответ.

Результаты. У 20 (71,5 %) пациентов отмечен полный клинический ответ после индукционного этапа лечения, у 7 (25 %) пациентов - частичный ответ. Стабилизация опухоли зарегистрирована у 1 (3,5 %), 2-летняя общая выживаемость составила 95,8 ± 4,1 %, выживаемость без прогрессирования - 90,1 ± 6,8 %.

Заключение. Предложенная в нашем исследовании тактика органосохранного лечения при раке гортани III-IV стадии с заменой системной химиотерапии на регионарную внутриартериальную перед проведением лучевой терапии является высокоэффективной как с точки зрения непосредственного противоопухолевого эффекта, так и с точки зрения безрецидивной и общей выживаемости.

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