复发或转移口腔鳞状细胞癌的时辰化疗

The chronochemotherapy of patients with recurrent or metastatic oral squamous cell carcinoma

目的分析比较用紫杉醇、卡铂和5-氟尿嘧啶（5-Fu）联合方案对复发和（或）转移口腔鳞状细胞癌（OSCC）行时辰化疗和传统化疗的疗效和不良反应。方法回顾分析49例用紫杉醇、卡铂联合5-Fu进行姑息化疗的复发和（或）转移的OSCC患者。因给药时间不同,分为时辰化疗组（28例）和传统化疗组（21例）。比较两组患者的有效率、中位总体生存时间、中位无进展生存时间和不良反应发生率。结果时辰化疗组的有效率和中位总体生存时间显著高于传统化疗组（有效率分别为71.43%、42.86%,P〈0.05;中位总体生存时间分别为15.3个月、10.6个月,P〈0.05）。时辰化疗组不良反应总体发生率、Ⅲ-Ⅳ级不良反应发生率显著低于传统化疗组患者（46.43%vs.76.19%,7.14%vs.33.33%,P〈0.05）。结论对于复发和（或）转移OSCC患者,紫杉醇、卡铂联合5-Fu方案时辰化疗较传统化疗可提高治疗有效率、延长生存时间并降低不良反应。

Objective To evaluate the effect and toxicities of chronochemotherapy with paclitaxel,carboplatin and 5-fluorouracil in patients with recurrent and/or metastatic oral squamous cell carcinoma（OSCC）.Methods Retrospective analyses were made on 49 patients with recurrent and/or metastatic OSCC who underwent palliative treatments with paclitaxel,carboplatin and 5-fluorouracil.The patients were divided into 2groups,a chronochemotherapy group（28patients）and a conventional chemotherapy group（21patients）,according to their administration times.The effective rate,median overall survival（OS）,median progression-free survival（PFS）,and the incidence of adverse events were compared between the two groups.Results The effective rate and patients′median OS were significantly higher and longer in the chronochemotherapy group than those in the conventional chemotherapy group（effective rate 71.43%vs.42.86%,respectively,P〈0.05;and median OS 15.3 months vs.10.6 months,respectively,P〈0.05）.The global incidence of adverse events in the chronomodulatedchemotherapy group was significantly lower than that in the conventional chemotherapy group（46.43%vs.76.19%,P〈0.05）,with significantly lower incidence of grade 3to 4adverseevents（7.14%vs.33.33%,P〈0.05）.Conclusion Chronochemotherapy with paclitaxel,carboplatin and 5-Fu can improve effective rate,prolong survival time and reduce the occurrence of adverse reaction for patients with recurrent and/or metastatic OSCC,when compared with conventional chemotherapy.