平阳霉素对口腔鳞癌化疗疗效与剂量关系的病例对照分析

Retrospective Study on Relationship between Dose of Pingyangmycin and Its Effect on Patiend with Oral Squamous Cell Carcinmoma

目的：在化疗早期根据肿瘤对平阳霉素的反应，判断平阳霉素对口腔鳞癌的疗效，使对平阳霉素效果差 的患者尽早停止化疗，以减少毒副反应的发生。方法：从本院近１６年来接受平阳霉素化疗的病例中，筛选出接受平 阳霉素治疗前未接受过化疗或放疗的 ７３例患者，按 ＷＨＯ疗效标准，分为有效组（３８例）与无效组（３５例）。首先确定 每个样本的最低显效剂量（肿瘤或溃疡开始缩小的平阳霉素累计用量），求其均数和标准差（ｘ±ｓ），然后以此作为样 本的最低显效剂量，确定每个样本在该剂量时是否开始显效，并时两组进行χ２检验。两组的最终剂量用ｔ检验进行 分析。结果：１）两组的最终剂量无显著性差异（Ｐ＞０．０５）。２）平阳霉素对口腔鳞癌化疗的最低显效剂量５９±１８ｍｇ，在此 剂量显效的患者，随剂量增加，疗效逐渐明显。在此剂量未显效的患者，随剂量增加，多数未出现疗效（Ｐ＜０．０１）。结 论：５９±１８ｍｇ可作为平阳霉素对口腔鳞癌化疗疗效的筛选剂量。

Objective To assess the response to pingyangmycin in patients with oral squamous cell carcinoma in early stage of preoperative chemotherapy. Methods: A total of 73 cases of oral squamous cell carcinoma previously untreated which received preoperative chemotherapy of pingyangmycin were divided into two groups: responders (CR+PR: 38 cases) and non-responders (SD+PD: 35 cases). After making sure of the minimal effective dose of every case and deciding whether the tumor size of every case reduced at the minimal effective dose (mean +SD). The statistic analysis was done between these two groups. Results: 1) The total dose of these two groups had no significant difference (P>0.05). 2) The cases of which tumor size had reduced at the minimal effective dose (59mg±18mg) usually had good response (P<0.01). Conclusion: Whether the tumor size reduced at the minimal effective dose may be a predictor of responsiveness to pingyangmycin in patients with oral squamous cell carcinoma.