口腔颌面部恶性肿瘤化疗药物敏感性临床分析

CLINICAL ANALYSIS OF CHEMOSENSITIVITIES OF ORAL AND MAXILLOFACIAL CANCERS

目的 恶性肿瘤化疗的一个最大问题是肿瘤对化疗药物的耐药性。MTT肿瘤药敏检测是一种定量比色体外药敏测定方法。本研究的目的是初步评价 MTT药敏检测结果对指导口腔肿瘤个体化化疗的临床意义。方法 应用 30例口腔颌面外科手术或活检的恶性肿瘤标本 ,进行常规 MTT药敏检测 ,同时将检测结果与临床资料进行对比性分析。检测药物共有 6种 :DDP、5 - Fu、VDS、MTX、E- ADM、PYM。结果 (1)病变部位以舌部为主 ,占30 % ,药物敏感性与肿瘤部位有关 ;(2 )检测 30例口腔颌面部恶性肿瘤组织的药敏性 ,所得结果与临床资料进行分析。8例采用传统经验用药方案进行化 ,其疗效与 MTT法检测的药敏结果一致 ;(3)大部分肿瘤对 DDP、5 - Fu有中度以上敏感性 ,但也有少部分存着抗 DDP、5 - Fu现象 ,这也是临床上采用传统经验用药方案 ,有些肿瘤化疗效果不理想的原因之一。结论 通过肿瘤药敏检测 ,找出对恶性肿瘤有效的化疗药物组成联合用药方案 ,可以做到化疗方案的个体化 。

Objective A major problem associated with chemotherapy for cancers is drug resistance. The MTT assay is a quantitative colorimetric system for the determination of the chemosensitivity of tumor cells in vitro. The aim of the present study is to evaluated the clinical significance of chemosensitivity testing on cells culture from fresh specimens for individual chemotherapy. Methods Thirty patients with oral and maxillofacial cancers were entered in this study. The samples which obtained from surgical and biopsical specimens were examined using MTT method, and climical data and chemosensitivity were analyzed and compared. The antitumor drugs tested were cisplation (DDP), 5 Fluorouracial (5 Fu), Vindesine (VDS), Methortrexatum (MTX), Pyromycin (PYM), Epi adriamycinum (E ADM).Results (1) The most common lesion was tongue, accouting for 30%, (2) 8 patients were treated with conventional chemotherapy, and the clinic outcomes were similar to results of chemosensitivity tesing using MTT assay; (3) Most of cancers showed the chemosensitivity to DDP、5 Fu, but some cancers still were resistanted to DDP、5 Fu. this was the one of causes of poor chemotherapeutic effect to some cancers.Conclusion Chemosensitivity testing using MTT assay appeared to be useful in selecting chemotherapeutic agents for patients with oral and maixllofacial cancers. This assay might be useful on an individual basis to optimize chemotherapy.