新辅助化疗在老年中晚期口腔鳞状细胞癌治疗中的临床意义

目的：探讨分析新辅助化疗在治疗老年中晚期口腔鳞状细胞癌中的临床效果。方法收集46例老年中晚期口腔鳞状细胞癌行新辅助化疗患者作为研究组，选取同期收治的60例未行新辅助化疗老年中晚期口腔鳞状细胞癌患者作为对照组，统计入组患者新辅助化疗后临床有效率、病理有效率，对比新辅助化疗前后细胞凋亡及增殖指数，肿瘤组织Ki-67、EGFR、p53及RARβ的表达变化，并分析新辅助化疗后手术及生存情况，比较两组生存率差异。结果研究组化疗后临床有效率和病理有效率分别为80.43%和69.57%。化疗后细胞凋亡指数明显高于化疗前，细胞增殖指数低于化疗前，差异均具有统计学意义（P=0.007、0.015）。化疗后Ki-67、EGFR、p53均低于化疗前，RARβ高于化疗前，差异均具有统计学意义（P=0.004、0.027、0.021、0.013）。研究组患者的中位生存期为28个月，新辅助化疗3、4个疗程患者远期生存率高于2个疗程患者，差异有统计学意义（P=0.021、0.017）。3个疗程和4个疗程化疗患者远期生存率比较差异无统计学意义（P=0.117）。对照组患者中位生存期为17个月，两组患者生存率差异具有统计学意义（P=0.015）。结论新辅助化疗可从多方面改善老年中晚期口腔鳞状细胞癌的临床效果，应成为其综合治疗的重要组成部分。

Clinical significance of neoadjuvant chemotherapy in aged patients with advanced oral squamous cell carcinoma

Objective To investigate the clinical significance of neoadjuvant chemotherapy in aged patients with ad-vanced oral squamous cell carcinoma (SCC). Method 46 elderly patients with advanced oral SCC who were treated with neoadjuvant chemotherapy were enrolled in the study as study group, and another 60 cases of oral SCC without neo-adjuvant chemotherapy were included as control group, the patients’clinical and pathological response rate after chemo-therapy were compared, besides, the cell apoptosis and proliferation indexes, expression of Ki-67, EGFR, p53 and RARβin tumor tissues, as well as survival in the two groups were analyzed. Result After chemotherapy, the clinical and patho-logical response rate was 80.43% and 69.57% respectively; The apoptosis index was significantly increased, while cell proliferation index was significantly lower after chemotherapy, with significant differences observed (P=0.007、0.015);The expression of Ki-67, EGFR, and p53 were decreased, while RARβwas increased after chemotherapy, which were of statistical significance (P=0.004、0.027、0.021、0.013);The median survival was 28 months in study group, and patients treated more than 3 cycles of neoadjuvant chemotherapy were of better long-term survival rate than those with cycles less than 2 (P=0.021、0.017);The long-term survival were similar among patients treated with 3 cycles and 4 cycles of chemo-therapy (P=0.117);The median survival time was 17 months in control group, which was significantly less than that of study group (P=0.015). Conclusion Neoadjuvant chemotherapy improves the clinical outcomes of aged patients with oral squamous cell carcinoma in many ways, enabling it to be an important part of comprehensive treatment.