老年口腔鳞癌患者皮下埋植泵动脉灌注新辅助化疗的临床研究

目的探讨CF化疗方案(卡铂加氟尿嘧啶)和CPM化疗方案(卡铂加平阳霉素加甲氨蝶呤)分别对老年口腔鳞癌患者行动脉灌注新辅助化疗和常规静脉给药新辅助化疗的疗效和不良反应。方法114例T2～T4老年口腔鳞癌患者均完成2个新辅助化疗疗程,随机分为4组(Ⅰ～Ⅳ),Ⅰ组(25例),CPM方案静脉给药化疗;Ⅱ组(32例),CPM方案动脉灌注化疗;Ⅲ组(21例):CF方案静脉给药化疗;Ⅳ组(36例),CF方案动脉灌注化疗。比较各组化疗2个疗程后的疗效和不良反应。结果2个化疗疗程后,Ⅰ～Ⅳ组有效率分别为44.00%、71.88%、47.62%、75.00%,不良反应发生率分别为64.00%、43.75%、66.67%、45.83%,CF方案和CPM方案行动脉灌注化疗均比常规静脉给药化疗能增加疗效,降低不良反应(P<0.05)。结论CF和CPM化疗方案对老年口腔鳞癌患者行动脉灌注新辅助化疗能达到减毒增效的目的。

Clinical study of intra-arterial infusion neoadjuvant chemotherapy for elderly patients with oral squamous cell carcinoma using subcutaneous implantable drug delivery system

Objective To investigate therapeutic effects and toxicities of CF(Carboplatin+5-Fluorouracil) and CPM (Carboplatin+Pingyangmycin+Methotrexate)chemotherapy schemes for the elderly patients with oral squamous cell carcinoma(OSCC)by intra-arterial infusion administration and routine vein administration, respectively. Methods 114 elderly patients with T2～T4 stages OSCC, admitted from Sep 2001 to June 2005, were collected and divided randomly into four groups(groupsⅠ～Ⅳ): groupⅠ(25 cases): Routine vein chemotherapy of CPM scheme; groupⅡ(32 cases): Intra-arterial infusion chemotherapy of CPM scheme; group Ⅲ (21 cases): Routine vein chemotherapy of CF scheme; groupⅣ: Intra-arterial infusion chemotherapy of CF scheme. Therapeutic effects and side effects among the four groups were compared. Results After two chemotherapy courses, the effective rates of groupsⅠ～Ⅳ were 44.00%,71.88%,47.62% and 75.00%, respectively; toxicities incidence rates of groupsⅠ～Ⅳwere 64.00%,43.75%,66.67% and 45.83%, respectively. The effective rate of groupⅡ was significantly higher than that of groupⅠ(P<0.05), and the toxicity incidence rate of groupⅡwas significantly weaker than that of groupⅠ(P<0.05). The effective rate of group Ⅳ was significantly higher than that of groupⅢ(P<0.05), and toxicities incidence rate of groupⅣ was significantly weaker than that of groupⅢ(P<0.05). Conclusion Intra-arterial infusion chemotherapy of CF scheme or CPM scheme for elderly patients with OSCC can increase therapeutic effects and reduce toxicity incidence rate, compared with routine vein chemotherapy.