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Ⅲ～Ⅳ期口腔鳞癌切除术前应用DCF方案诱导化疗的临床观察
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| 篇名： | Ⅲ～Ⅳ期口腔鳞癌切除术前应用DCF方案诱导化疗的临床观察 |
| TITLE： | |
| 摘要： | 目的：观察Ⅲ～Ⅳ期口腔鳞癌切除术前应用地塞米松+多西他赛+顺铂+氟尿嘧啶（DCF）方案诱导化疗的疗效和安全性。方法： 120例Ⅲ～Ⅳ期口腔鳞癌患者随机分为对照组（60例）和观察组（60例）。两组患者均给予口腔癌扩大切除，对照组患者于术后4～6周后开始放疗；观察组患者在对照组治疗的基础上于术前给予醋酸地塞米松片0.75 mg，口服，每日1次，d1－7+多西他赛注射液80 mg/m2，加入0.9％氯化钠溶液250 mL中，静脉滴注2 h，d2+注射用顺铂80 mg/m2，加入0.9％氯化钠溶液250 mL中，静脉滴注1 h，d2+氟尿嘧啶注射液750 mg/m2，加入0.9％氯化钠溶液500 mL中，静脉滴注，d2－5。两组均以7 d为1个疗程。观察两组患者的临床疗效，治疗前后生命质量测定（EORTC QLQ-C30）量表评分，12、24、36个月复发率及不良反应发生情况。结果：观察组患者近期总有效率显著高于对照组，随访12、24、36个月复发率均显著低于对照组，观察组患者Ⅰ～Ⅱ度恶心呕吐、白细胞减少发生率均显著高于对照组，差异均有统计学意义（P＜0.05），但两组患者Ⅲ～Ⅳ度恶心呕吐、白细胞减少及Ⅰ～Ⅱ、Ⅲ～Ⅳ度腹泻发生率比较，差异均无统计学意义（P＞0.05）。治疗前，两组患者EORTC QLQ-C30量表评分比较，差异均无统计学意义（P＞0.05）。治疗后，两组患者EORTC QLQ-C30量表评分均显著低于同组治疗前，差异均有统计学意义（P＜0.05）；但两组间比较差异无统计学意义（P＞0.05）。结论：Ⅲ～Ⅳ期口腔鳞癌切除术前应用DCF方案诱导化疗可提高近期疗效，降低远期复发风险，但Ⅰ～Ⅱ度恶心呕吐、白细胞减少发生率较高。 |
| ABSTRACT： | OBJECTIVE： To observe therapeutic efficacy and safety of applying dexamethasone+docetaxel+cisplatin+fluorouracil （DCF） regimen induction chemotherapy before Ⅲ-Ⅳ stage oral squamous cell carcinoma resection. METHODS： A total of 120 patients with Ⅲ-Ⅳ stage oral squamous cell carcinoma were randomly divided into control group（60 cases） and observation group（60 cases）. Both groups were given oral cancer resection， control group received radiotherapy 4-6 weeks after surgery，observation group was additionally given Dexamethasone acetate tablets 0.75 mg orally once a day， d1-7+Docetaxel injection 80 mg/m2 added into 0.9％ Sodium chloride solution 250 mL intravenously for 2 h， d2+Cisplatin injection 80 mg/m2 added into 0.9％ Sodium chloride solution 250 mL intravenously for 1 h， d2+Fluorouracil injection 750 mg/m2 added into 0.9％ Sodium chloride solution 500 mL intravenously， d2-5. Treatment course of 2 groups lasted for 7 d. Clinical efficacies of 2 groups were observed as well as EORTC QLQ-C30 score before and after treatment， recurrence rate 12， 24， 36 months and the occurrence of ADR. RESULTS： The short-term total response rate of observation group was significantly higher than that of control group； 12， 24， 36 months follow-up recurrence rate of observation group were significant lower than those of control group； the incidence ofⅠ-Ⅱdegree nausea and vomiting， leucopenia in observation group were significantly higher than control group， with statistical significance （P＜0.05）； there was no statistical significance in the incidence of Ⅲ-Ⅳ degree nausea and vomiting， leucopenia andⅠ-Ⅱ，Ⅲ-Ⅳ degree diarrhea between 2 groups （P＞0.05）. Before treatment， there was no statistical significance in EORTC QLQ-C30 score between 2 groups （P＞0.05）. After treatment， EORTC QLQ-C30 score of 2 groups were significantly lower than before， with statistical significance （P＜0.05），but there was no statistical significance between 2 groups （P＞0.05）. CONCLUSIONS： The applying of DCF regimen induction chemotherapy can improve short-term efficacy before Ⅲ-Ⅳstage oral squamous cell carcinoma resection， reduce reoccurrence risk but induce high incidence ofⅠ-Ⅱdegree nausea and vomiting， leucopenia. |
| 期刊： | 2017年第28卷第12期 |
| 作者： | 孟昭忠，李闯，王超 |
| AUTHORS： | MENG Zhaozhong，LI Chuang，WANG Chao |
| 关键字： | 地塞米松；多西他赛；顺铂；氟尿嘧啶；诱导化疗；口腔鳞癌；疗效；安全性 |
| KEYWORDS： | Dexamethasone； Docetaxel； Cisplatin； Fluorouracil； Induction chemotherapy； Oral squamous cell carcinoma； Therapeutic efficacy； Safety |
| 阅读数： | 221 次 |
| 本月下载数： | 3 次 |
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