TNPP方案对头颈部鳞癌术前化疗57例临床疗效分析

目的:探讨头颈部鳞癌新辅助化疗TNPP方案(紫素 奈达铂 替加氟 强的松)的临床效果。方法:自2005年6月～2007年4月,我科共收治头颈部鳞癌患者57例,全部病例手术前经切检或针刺细胞学检查,病理经我院会诊均证实为头颈部鳞癌(舌鳞癌、腭鳞癌、口底鳞癌、颊黏膜鳞癌、牙龈鳞癌、喉癌等),且Ⅰ～Ⅳ期均有。采用TNPP方案术前化疗1～2个周期,化疗后1周行手术治疗,根据化疗后大体测量及术后病理判断肿瘤分期变化,推断疗效。结果:新辅助化疗的57例中,化疗后经大体测量肿瘤原发灶,转移淋巴结以及术后病理检查,肿瘤分期降低者37例(64.9%),其中7例术后病理证实原发灶未发现瘤组织。结论:术前新辅助化疗可以降低头颈部鳞癌的TNM分期,并使部分晚期患者获得根治性手术的机会,降低局部复发率,保留功能并提高病人生存率及生活质量。

Analyze the effect of neoadjuvant chemotherapy with TNPP to squamous cell carcinoma of head and neck

Objective: To observe the effect of neoadjuvant chemotherapy with TNPP(Tegafur Nedaplatin Paclitaxel Prednisone) to squamous cell carcinoma in the head and neck.Methods:From June,2005 to April,2007,57 patients,certified to have squamous cell carcinoma of the head and neck by biopsy or FNA before operation,were received neoadjuvant chemotherapy of TNPP for one or two circles.One week after chemotherapy,they were performed surgery.The change of tumor stage was deduced from gross changing of primary site and metastasized lymph nodes and pathological result.Results:Among these 57 cases,tumor stages of 37 cases(64.9%) were reduced while 7 cases had no tumor tissue remained by pathological inspect postoperation.Conclusion: preoperative neoadjuvant chemotherapy can limit aggressive growth of squamous cell carcinoma in the head and neck,which benefit to totally resect malignant tumor,reducing the recurrence rate and improving the quality of life of patients.