多烯紫杉醇联合顺铂和氟尿嘧啶诱导化疗对口腔鳞癌的近期疗效观察

The observation of short-term effect of induction chemotherapy of docetaxel combined with cisplatin and fluorouracil for oral mucosal squamous cell carcinoma

目的:观察多烯紫杉醇联合顺铂和5-氟尿嘧啶(DCF方案)诱导化疗对口腔黏膜鳞状细胞癌的近期疗效和不良反应。方法:51例患者均经病理组织学证实为口腔黏膜鳞癌,均接受1个疗程的DCF方案(多烯紫杉醇80mg/m2,顺铂80mg/m2,5-氟尿嘧啶750mg/m2×4d)化疗,并配合水化利尿、止吐及抗过敏等辅助治疗。平均21d后评定疗效,施行原发肿瘤局部扩大切除的联合根治术。化疗前详细记录病灶大小,采用WHO推荐评价实体肿瘤客观指标判定疗效,分为完全缓解、部分缓解及无效3级,总有效率为完全缓解+部分缓解病例。结果:近期疗效中,完全缓解12例,部分缓解27例,无效12例,总有效率(CR+PR)为76.47%(39/51)。未出现严重不良反应。结论:DCF方案对多数口腔颌面部鳞癌近期疗效明显,不良反应可以耐受,远期疗效尚待进一步研究证实。

PURPOSE： To observe the short-term effect and adverse reaction of DCF induction chemotherapy protocol （docetaxel combined with cisplatin and 5 – fluorouracil）for oral mucosal squamous cell carcinoma. METHODS： Fifty one patients confirmed to be oral mucosal squamous cell carcinoma by histopathology, received a course of DCF protocol （docetaxel 80mg/m^2, cisplatin 80mg/m^2, 5-fluorouracil 750mg/m^2 ×4d）,and adjuvant therapy-hydration with diuretic, antiemetic and anti-allergy treatment. After clinical evaluation at （21±1）d, combined radical surgery of the primary tumor was performed. The lesion size of tumor was recorded before chemotherapy in details, and objective indicators of solid tumors evaluation recommended by WHO was adopted to determine the curative effect （1981）. There were three levels： complete remission, partial remission and no mitigation, the effective rate was percentage of CR＋PR cases among the total cases. RESULTS： In short-term effect, CR was seen in 12 cases, PR in 27 cases, NC in 12 cases, the total effective rate （CR＋PR） was 76.47% （39/51）. Toxicity was minor and occurs did not affect the application of this therapy. CONCLUSIONS： DCF combination chemotherapy is an effective and tolerable regimen in patients with oral mucosal squamous cell carcinoma,but the long-term effect need to be confirmed by further studies.