舌癌动/静脉辅助化疗的临床疗效观察
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摘要
目的:观察选择性舌动脉灌注新辅助化疗对舌癌的疗效。方法:50例舌癌患者随机分成2组,A组(27例)选择性舌动脉新辅助化疗27例,B组(23例)静脉辅助化疗23例,化疗方案选择对舌癌高效敏感的DF方案(卡铂+5-氟尿嘧啶)。观察化疗前、后原发灶和颈转移淋巴结大小,评估化疗后原发灶临床有效率、原发灶和淋巴转移灶化疗后病理学分级。结果:原发灶化疗临床有效率:A组92.59%,B组69.56%(P<0.05);原发灶化疗后病理学分级中,III+IV级百分比:A组81.48%, B组39.11%(P<0.05);淋巴结转移灶化疗后病理学分级中,III+IV级百分比:A组80.00%, B组33.33%(P<0.05)。结论:选择性经舌动脉辅助化疗治疗舌癌较经静脉化疗提高了原发灶和转移淋巴结的控制率。
Objective: To evaluate the effects of the selective lingual artery in the treatment of tongue cancer underwent neoadjuvant chemotherapy DF program(Carboplatiin+5-FU). Methods: 50 cases of tongue cancer were randomly divided into two groups. Group A(n=27): patients were treated by the lingual artery neoadjuvant chemotherapy. Group B(n=23): patients were treated by transvenous neoadjuvant chemotherapy. Before and after treatment primary foci and metastatic cervical lymph node size were examined, clinical efficiency and pathological classification were evaluated. Results : The clinical efficiency of group A and B was 92.59% and 69.56%(P<0.05), after treatment tumor pathological classification of III+IV stage(%) of group A and B was 81.48% and 39.11%(P<0.05), cervical lymph node metastases with the pathological grade of III+IV grade(%) of group A and B was 80% and 33.33%(P<0.05), respectively. Conclusion: Neoadjuvant chemotherapy via lingual artery is more effectively than than that via vein chemotherapy in the treatment of tongue cancer.
Objective: To evaluate the effects of the selective lingual artery in the treatment of tongue cancer underwent neoadjuvant chemotherapy DF program(Carboplatiin+5-FU). Methods: 50 cases of tongue cancer were randomly divided into two groups. Group A(n=27): patients were treated by the lingual artery neoadjuvant chemotherapy. Group B(n=23): patients were treated by transvenous neoadjuvant chemotherapy. Before and after treatment primary foci and metastatic cervical lymph node size were examined, clinical efficiency and pathological classification were evaluated. Results : The clinical efficiency of group A and B was 92.59% and 69.56%(P<0.05), after treatment tumor pathological classification of III+IV stage(%) of group A and B was 81.48% and 39.11%(P<0.05), cervical lymph node metastases with the pathological grade of III+IV grade(%) of group A and B was 80% and 33.33%(P<0.05), respectively. Conclusion: Neoadjuvant chemotherapy via lingual artery is more effectively than than that via vein chemotherapy in the treatment of tongue cancer.
引文
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[11] 张立刚, 黄桂林, 胡小华, 等. 紫杉醇脂质体对兔舌癌淋巴结转移癌细胞凋亡的研究[J]. 实用口腔医学杂志, 2016, 32(5): 607-610.
[12] Zhang NN, Zhang LG, Liu ZN, et al. Therapeutic efficacy of paclitaxel and carboplatin via arterial or venous perfusion in rabbits with VX-2 tongue cancer[J]. Int J Clin Exp Med, 2015, 8(4): 4979-4988.
[13] Yokoyama J, Ohba S, Ito S, et al. Impact of lymphatic chemotherapy targeting metastatic lymph nodes in patients with tongue cancer (cT3N2bM0) using intra-arterial chemotherapy[J]. Head Neck Oncol, 2012, 4(2): 64-70.
[14] 詹晓星, 颜小琼. 介入放射学中的药代动力学研究[J]. 国外医学临床放射性分册, 1989, 6: 327-329.
[15] 胡小华, 黄桂林, 张霓霓, 等. 口腔癌持续性动脉灌注新辅助化疗的疗效观察[J]. 中国肿瘤临床, 2012, 39(18): 1382-1385.
[16] 邱蔚六, 薛晓帆, 刘瑷如. 口腔颌面部鳞癌术前辅助化疗的评价[J]. 华西口腔医学杂志, 1991, 9(3): 167-173.
[2] 唐岳鹏, 黄桂林, 胡小华, 等. 数字减影血管造影技术在头颈部恶性肿瘤区域性动脉灌注化疗中的应用[J]. 实用口腔医学杂志, 2011, 27(6): 782-784.
[3] 邱蔚六, 郑家伟. 应重视口腔颌面部恶性肿瘤的综合序列治疗[J].中国口腔颌面外科杂志, 2005, 3(3): 179-182.
[4] Shimosato Y,Oboshi S,Baba K.Histological evaluation of effects of radiotherapy and chemotherapy for carcinomas[J]. Japanese Journal of Clinical Oncology, 1971, 1(1): 19-35.
[5] Kirita T, Shimooka H, Yamanaka Y, et al. Prognostic value of response to preoperative chemoradiotherapy and residual tumor grades in tongue carcinoma[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2001, 91(3): 293-300.
[6] 邱蔚六. 口腔颌面部癌瘤治疗的新理念-浅析综合序列治疗[J]. 上海第二医科大学学报, 2005, 25(4): 321-328.
[7] 邱尉六. 中国口腔领面肿瘤学进展50年[J]. 中华口腔医学杂志,2002, 37(3): 161-164.
[8] Grau JJ, Domingo J, Blanch JL, et al. Multidisciplinary approach in advanced cancer of the oral cavity: Outcome with neoadjuvant chemotherapy according to intention-to-treat local therapy. A phase II study[J]. Oncology, 2002, 63(4): 338-345.
[9] Zhong LP, Zhang CP, Ren GX, et al. Randomized phase III trial of induction chemotherapy with docetaxel, cisplatin, and fluorouracil followed by surgery versus up-front surgery in locally advanced resectable oral squamous cell carcinoma[J]. J Clin Oncol, 2013, 31(6): 744-751.
[10] 张林, 黄桂林. 兔VX2口腔鳞状细胞癌模型的研究进展[J]. 遵义医学院学报, 2013, 36(2): 174-176.
[11] 张立刚, 黄桂林, 胡小华, 等. 紫杉醇脂质体对兔舌癌淋巴结转移癌细胞凋亡的研究[J]. 实用口腔医学杂志, 2016, 32(5): 607-610.
[12] Zhang NN, Zhang LG, Liu ZN, et al. Therapeutic efficacy of paclitaxel and carboplatin via arterial or venous perfusion in rabbits with VX-2 tongue cancer[J]. Int J Clin Exp Med, 2015, 8(4): 4979-4988.
[13] Yokoyama J, Ohba S, Ito S, et al. Impact of lymphatic chemotherapy targeting metastatic lymph nodes in patients with tongue cancer (cT3N2bM0) using intra-arterial chemotherapy[J]. Head Neck Oncol, 2012, 4(2): 64-70.
[14] 詹晓星, 颜小琼. 介入放射学中的药代动力学研究[J]. 国外医学临床放射性分册, 1989, 6: 327-329.
[15] 胡小华, 黄桂林, 张霓霓, 等. 口腔癌持续性动脉灌注新辅助化疗的疗效观察[J]. 中国肿瘤临床, 2012, 39(18): 1382-1385.
[16] 邱蔚六, 薛晓帆, 刘瑷如. 口腔颌面部鳞癌术前辅助化疗的评价[J]. 华西口腔医学杂志, 1991, 9(3): 167-173.
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