手术联合间质化疗及常规化疗治疗口腔鳞状细胞癌对比性研究

A Comparative Study of Surgery Combined with Interstitial Chemotherapy and Conventional Chemotherapy in the Treatment of Oral Squamous Cell Carcinoma

目的探讨手术联合术前间质化疗对口腔鳞状细胞癌(OSCC)的临床疗效。方法选取皖南医学院附属弋矶山医院2013年1月—2015年9月收治的原发性OSCC患者52例,随机分为实验组和对照组,各26例。对照组:手术联合常规化疗,实验组:手术联合间质化疗,比较两组近期疗效、血清Cyfra21-1和肿瘤坏死因子-α(TNF-α)水平的变化、复发率以及不良反应发生率。结果实验组总有效率(88.46%)显著高于对照组(65.38%),差异有统计意义(P<0.05);实验组治疗后血清Cyfra21-1水平低于对照组(P<0.01),TNF-α水平高于对照组(P<0.001);随访24个月,实验组总复发率(15.38%)显著低于对照组(42.31%),差异有统计学意义(P<0.05);实验组各不良反应发生率均低于对照组,但差异无统计学意义(P>0.05)。结论与常规化疗相比,间质化疗联合手术可明显提高近期疗效,降低复发率,还可在一定程度上减轻药物的全身毒副反应。

Objective This paper tries to investigate the clinical efficacy of surgery combined with preoperative interstitial chemotherapy for oral squamous cell carcinoma(OSCC).Methods 52 patients with primary OSCC admitted to the hospital from January 2013 to September 2015 were selected and were randomly divided into the experimental group and the control group,with 26 cases in each group.The control group was treated with surgery combined with conventional chemotherapy,and the experimental group was treated with surgery combined with interstitial chemotherapy.The short-term efficacy,changes of serum Cyfra21-1 and tumor necrosis factor-alpha(TNF-α),recurrence rate and incidence of adverse reactions were compared between the two groups.Results The total effective rate of the experimental group(88.46%)was significantly higher than that of the control group(65.38%),and the difference was statistically significant(P<0.05);after treatment,the serum Cyfra21-1 level of the experimental group was significantly lower than that of the control group(P<0.01),and the level of TNF-αwas significantly higher than that of the control group(P<0.001);after 24 months of follow-up,the total recurrence rate of the experimental group(15.38%)was significantly lower than that of the control group(42.31%),and the difference was statistically significant(P<0.05);The incidence of adverse reactions in the experimental group was lower than that in the control group,but the difference was not statistically significant(P>0.05).Conclusion Compared with the conventional chemotherapy,interstitial chemotherapy combined with surgery can significantly improve the short-term efficacy,reduce the recurrence rate,and also can reduce the systemic toxic and side effects to a certain extent.