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作者们对43例(男37,女6;年龄21-75岁)未经治疗的头颈部Ⅲ、Ⅳ期晚期鳞癌行化疗的结果进行分析。治疗前均经全面体检和X线检查以确定癌肿范围,其中20例有颈淋巴结转移。原发部位:鼻和上颌-筛窦9例,软腭4,扁桃体1,舌根3,颊粘膜5,口底3,舌前半1,喉和喉咽部7。治疗采用两种方案:20例单用氨甲喋呤,50mg/周静脉给药;另23例用氨甲喋呤50mg和5-Fu 500mg静脉内给予,继后口服环磷酰胺每次100m g,日三次,持续一周。在经上法治疗后,如有手术指征者应行手术切除;反之,可按上法继续化疗,同时密切观察血像变化。本文43例中有14例于化疗后行手术切除。
The authors analyzed the results of chemotherapy in 43 patients (37 males, 6 females, and 21 to 75 years of age) with untreated squamous cell carcinoma of the head and neck stage III and IV. Before treatment, comprehensive physical examination and X-ray examination were performed to determine the extent of cancer, of which 20 cases had cervical lymph node metastasis. Primary sites: 9 cases of nasal and maxillary-ethmoid sinus, soft palate 4, tonsil 1, tongue base 3, buccal mucosa 5, floor of the mouth 3, anterior half of the tongue 1, throat and hypopharynx 7. There are two options for treatment: 20 cases with methotrexate alone, 50 mg/week for intravenous administration; another 23 cases with methotrexate 50 mg and 5-Fu 500 mg given intravenously, followed by oral cyclophosphamide 100 mg g once daily for three times for a week . After the treatment with Shangfa, any surgical indications should be removed by surgery; otherwise, chemotherapy can be continued according to the above method and blood changes can be observed closely. Of the 43 cases, 14 cases were surgically removed after chemotherapy.