头颈鳞癌的术前化疗效果

Effect of Neoadjuvant Chemotherapy for Squamous Cell Carcinoma of Head and Neck

[目的]研究术前化疗能否提高手术切除率，降低局部复发率。［方法］104例头颈鳞癌病人分成试验组（58例）：术前化疗+手术+术后放疗组；对照组（46例）：手术+术后放疗，但不用术前化疗。手术方式为原发癌切除+颈淋巴结清扫术，用或不用肌皮瓣修复头颈部组织缺损。术后放疗剂量50Gy～60Gy。术前化疗用PFP方案即DDP＋5－Fu＋PYM。［结果］试验组部分缓解67.2%，微效17.2%。试验组和对照组3年局部复发率分别为27.6%、52．2％（P＜0.01）；但3年内远处转移率无差异，分别为34．5%、34．8%，中位生存期分别为23个月和22个月，3年生存率分别为65．5%和56．5%（P＞0.05）。［结论］术前新辅助化疗，可以缩小瘤体，提高手术切除率，减少局部复发。

Purpose To investigate the effect of neoaduvant (preoperative) chemotherapy for squamous cell carcinoma of head and neck.Methods Of 104 eligible patients with stage Ⅲ～Ⅳ squamous cell carcinoma ofhaad and neck, 58 were randonhtal to naive preopehoveclletnoherapy and sump folwh by postoperative radiotherapy (group Ⅰ); 46 were rdndonital to receive surgery without preoperativechemotherapy and opwtve radiotherapy (group Ⅱ). [Results] Pallial mpse rate we 67. 2% in group Ⅰ Patients. In 3 years follow - uprertto roponat rmrrence was 27.6% in pep Ⅰ and 52. 2% in group Ⅱ respectively (p < 0.01 ) .The edian lerval tirne ra 23 nsonths ingup Ⅰ and 22 rmths in group Ⅱ,mpively (no stuistical difference). [ Cunlusion ] Neoadiuvant chemOtheraPy is able t0 whce the size oftumer, incme the chance of complete resection and decra the raes of ndonal mrrence.