长春新碱和甲氨蝶呤行口腔鳞癌术前新辅助化疗的临床研究

目的:观察长春新碱(vincristine)和甲氨蝶呤(methotrexate)新辅助化疗方案(VM方案)在口腔鳞状细胞癌治疗中的临床疗效.方法:对联合应用长春新碱和甲氨蝶呤行新辅助化疗的45例口腔鳞癌患者(辅助化疗组)和既往术前未作任何辅助治疗的50例口腔鳞癌患者(对照组)进行回顾性分析,辅助化疗组术前接受1个疗程的VM方案化疗后进行手术,术后两组接受同样治疗.统计辅助化疗组化疗疗效、术后肿瘤复发率、不良反应和生存质量评分,比较两组患者的术后肿瘤复发率和生存质量评分.结果:经1个疗程VM化疗方案治疗后,45例口腔鳞癌患者中临床部分缓解26例(57.8%),稳定19例(42.2%),化疗总有效率57.8%.VM方案不良反应小,不影响患者接受手术治疗.随访期间辅助化疗组出现肿瘤复发10例(22.2%)、肿瘤远处转移4例(8.9%),对照组出现复发21例(42.0%),转移14例(28.0%),组间比较差异有显著性.结论:术前应用长春新碱和甲氨蝶呤联合化疗在口腔鳞癌治疗中疗效显著,能提高患者生存质量.

Clinical study of the combination of vincristine and methotrexate as neoadjuvnnt chemotherapy regimen in the treatment of squamous carcinoma in oral cavity

Objective:To evaluate the clinical efficacy of vincristine and methotrexate as the neoadjuvant chemotherapy regimen in the treatment of squamous carcinoma in oral cavity.Methods:45 patients with squamous carcinoma in oral cavity(adjuvant chemotherapy group) were treated with vincristine and methotrexate chemotherapy before operation from January of 2004 to June of 2006.In the control group,50 patients with squamous carcinoma in oral cavity were not treated with vincristine and methotrexate chemotherapy before operation.All patients were treated with operation.They had the same treatment after operation.The curative effect,tumor recurrence rate and survival quality score of adjuvant chemotherapy group were added up.The tumor recurrence rate and survival quality score of two groups were compared.Results:After one course of treatment of vincristine and methotrexate in the adjuvant chemotherapy group,PR was 57.8%(26/45),SD was 42.2%(19/45).The total effective rate was 57.8%.The adverse reaction of adjuvant chemotherapy was minor.All patients were treated with operation.In the follow-up period of adjuvant chemotherapy group,10 cases(22.2%) recurred and 4 cases(8.9%)metastasized,while in the control group they were 21 cases(42.0%) and 14 cases(28.0%),the difference between two groups was significance.The survival quality score of adjuvant chemotherapy group was higher than that of the control group.Conclusion:The combination treatment of vincristine and methotrexate before operation is a good tolerated regimen as neoadjuvant chemotherapy for squamous carcinoma in oral cavity.