摘要
本文总结我院１９８６年１月～１９９３年１２月住院治疗的临床Ⅳ期舌鳞癌病例４５例，其中完成平阳霉素单药新辅助化疗组病例２０例；１７例病人未行新辅助化疗。平阳霉素总量控制在２５０～３００ｍｇ。休息３周后进行舌癌联合根治术。该方案使部分晚期病例的原发灶有所缩小，从不适合手术到可以进行手术治疗。其１、３、５年生存率分别为６０％，５０％，４０％。两组的死亡都以局部复发为主（５５％：４７．１％）。两组间的局部复发率和５年生存率差异虽无统计学意义（Ｐ＞０．０５），但从临床数字的绝对值看，新辅助化疗组结果尚不理想。这可能与病例数较少有关。同时也提示，单药诱导化疗的方案似不适用于晚期舌鳞癌的病例。我们感到，新辅助化疗的近期疗效不能预示其局部治疗中的中长期疗效，也不宜用于推测病例的生存时间。平阳霉素单药新辅助化疗在降低晚期舌癌局部复发率和提高中长期生存率方面尚无明显的进步。为此，有必要进一步改进和完善舌鳞癌的新辅助化疗方案。
Abstract Forty-five patients with tongue carcinoma stage Ⅳ were treated in our hospital be- tween January 1 986 and December 1 993. In this series , twenty patients received neoad- juvant chemotherapy using Bleomycin-A5 preoperatively with the doses from 250 to 300 mg. They were treated by surgery after tree weeks (group A ) . Eight patients did not receive complete chemotherapy with the Bleomycin-A5 only 1 50mg (group B) . Seven- teen patients were treated by surgery alone (group C ) . All 45 patients were followed up over 5 years. Result showed that the survival rate of 1- , 3- , and 5-year was 60% ( 12/ 20), 50% (10/20), and 40% (8/20) respectively in group A, 64. 7% (11/17), 47. 1% (8/17) , and 47. 1% (8/17) respectively in group C. Comparing group A with group C, the local recurrence was the main cause of death ( 55. 0% vs 47. 1 % ) , and no signifi- cante differences between local recurrence and long-term survivors ( P > 0. 05 ) . It showed that Bleomycin-A5 alone as neoadjuvant supply might not be suitable for ad- vanced cases of tongue cancer. The outcome of the neoadjuvant chemotherapy is not beneficial to evaluate mid or long-term results of treatment and survivor although partial cases were PR (40%) or MR (25%) for induce chemotherapy, and had beneficial surg- ery ( group A ) . It need to be researched and improved the scheme of neoadjuvant chemotherapy for advanced squamous cells carcinoma of tongue.
出处
《耳鼻咽喉（头颈外科）》
1998年第6期362-364,共3页
Chinese Arch Otolaryngology-Head Neck Surg
