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 |
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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 |
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