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近20年来,由于手术和/或放疗的改进,提高了局部-区域性的控制,故对上呼吸道癌和上消化道癌的治疗已有明显进展,但要进一步提高病人的生存率,则尚需依靠化疗和免疫治疗。本文对化疗在头颈部癌的使用作一简要回顾。一、理论上的条件:一般所有类型的化疗都应在效力-毒性的狭窄范围内(译者:即疗效好、毒性小者)选择药物。另上呼吸道和上消化道癌化疗的效果与癌瘤的部位和细胞动力学亦有关。上呼吸道和上消化道癌主要是局部-区域性的侵犯。其转移率临床所见最多为10～15%,尸检发现的转移率虽较高,也不超过50%;但有些病例,如口咽、口底癌的转移率可达25%。失败的主要原因是化疗对这种局部-区域性的复发没有多少作用。据细胞动力学的资料表明,大多上呼吸道和上消化道癌静止细胞的百分率甚高,平均约为60～75%,故化疗的效果不佳;但在樱红色
In the past 20 years, due to the improvement of surgery and/or radiotherapy, local-regional control has been improved. Therefore, there has been significant progress in the treatment of upper respiratory tract cancer and upper gastrointestinal cancer. However, to further improve the survival rate of patients, Relies on chemotherapy and immunotherapy. This article gives a brief review of the use of chemotherapy in head and neck cancers. First, the theoretical conditions: In general all types of chemotherapy should be within the narrow range of efficacy - toxicity (Translator: the efficacy is good, less toxic) selected drugs. Another effect of chemotherapy on the upper airway and upper gastrointestinal cancer is also related to the location and cellular dynamics of the cancer. Upper airway and upper gastrointestinal cancers are mainly local-regional violations. The rate of metastases seen in the clinic is at most 10 to 15%. Although the metastasis rate found at autopsy is relatively high, it does not exceed 50%. However, in some cases, the metastasis rate of oropharyngeal and floor cancer can reach 25%. The main reason for the failure is that chemotherapy has little effect on this local-regional recurrence. According to the data from cell dynamics, the percentage of quiescent cells in the upper respiratory tract and upper gastrointestinal cancer is very high, averaging about 60 to 75%, so the effect of chemotherapy is not good; but in cherry red