缓释型氟尿嘧啶局部植入治疗口腔癌的初步研究

Treatment of oral squamous carcinoma by surgery combined with sustained release fluorouracil interstitial chemotherapy

目的探讨口腔癌局部植入缓释型氟尿嘧啶间质化疗加手术及全身化疗的疗效及安全性。方法间质化疗组:22例患者实施口腔鳞癌根治手术及全身静脉化疗,术前在癌灶内及癌灶周边植入缓释型氟尿嘧啶间质化疗药物,平均用药剂量为300mg;对照组18例为手术结合全身静脉化疗患者。两组均随访36个月,比较其术后复发率以及各种化疗毒副反应。SPSS统计软件进行统计分析。结果随访观察的患者中,间质化疗组术后24、36个月的复发率低于静脉化疗组(P<0.05),且其毒副反应与对照组无显著性差异(P>0.05)。结论手术切除+全身化疗结合局部癌灶植入缓释氟尿嘧啶间质化疗药物,可以提高肿瘤局部化疗药物的浓度,延长作用时间,在不增加毒副反应的同时提高疗效及生存质量。

Objective To investigate the therapeutic effect and safety of surgery and systemic chemotherapy with additional interstitial chemotherapy by biodegradable polymers coated 5-FU locally implanted in oral squamous carcinoma.Methods The patients diagnosed with advanced squamous carcinoma were randomly divided into two groups：the control group and the group with interstitial chemotherapy.18 patients in the control group were treated by surgery and venous chemotherapy.In the interstitial chemotherapy group,in addition to the same treatment as the control,5-fluorouracil sustained release capsule was additionally planted in 22 patients＇ tumor bed at a dose range from 300 mg before surgery.All the patients were followed up for 36 months.Recurrence rate,mortality rate and side effects were compared between two groups.The data were processed by SPSS statistical software.Results After additional treatment with interstitial chemotherapy,the 24-month recurrence rate and 36-month recurrence rate were significantly lower than the control group（P0.05）.No more serious side effects in the additional interstitial chemotherapy group were observed compared with the control（P〉0.05）.Conclusion Oral squamous carcinoma with additional interstitial chemotherapy by Fluorouracil sustained release would prolong the survival without significant side-effects,which might act by increasing local drug concentration and extend action time.