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目的:观察应用PVP方案对158例口腔黏膜鳞癌<4 cm的T1T2期患者(治疗组)与131例未行诱导化疗直接手术的T1T2期(对照组A)及764例行术前诱导化疗的T3T4期(对照组B)患者进行近期和中期疗效的对比分析。方法:收集1986～2008年间治疗的治疗组与对照组A或对照组B患者,均经病理组织学证实为口腔黏膜鳞状细胞癌,治疗组及对照组B均接受一个疗程的PVP方案化疗,并配合水化、利尿、止吐、抗过敏等辅助治疗,(21±1)d评定疗效后施行原发癌肿扩大切除+颈淋巴清扫的联合根治手术。对照A组则未行诱导化疗,直接施行原发癌肿扩大切除+颈淋巴清扫的联合根治手术。结果:治疗组与对照组B近期疗效分别达87.97%(39/158)、86.51%(661/764),实验组与对照组A、B中期疗效分别达到84.18%(133/158)、74.81%(98/131)、67.67%(517/764)。治疗组与对照组A和对照组B分别经x2检验分析,P<0.05,具有统计学意义。结论:T1T2期口腔黏膜鳞癌的术前诱导化疗具有提高生存率的作用,其中肿瘤直径大小对中期生存率的影响具有统计学意义。
OBJECTIVE: To observe the effect of PVP on T1T2 in 158 patients with oral mucosa squamous cell carcinoma <4 cm (treatment group) and 131 patients in T1T2 without direct chemotherapy (control group A) and 764 patients who underwent preoperative chemotherapy T3T4 phase (control group B) in patients with short-term and mid-term efficacy of comparative analysis. Methods: The patients in treatment group and control group A or control group B who were treated between 1986 and 2008 were all confirmed to be pathological diagnosis of oral mucosa squamous cell carcinoma. The treatment group and control group B received one course of chemotherapy with PVP regimen. And with hydration, diuretic, antiemetic, anti-allergy and other adjuvant therapy, (21 ± 1) d after curative effect assessment of the expansion of the primary tumor removal + neck lymph node dissection combined radical surgery. Control group A did not induce chemotherapy, the direct implementation of primary cancer enlargement and excision + neck lymph node dissection combined radical surgery. Results: The short-term curative effects of treatment group and control group B were 87.97% (39/158) and 86.51% (661/764), respectively. The interim results of A and B in experimental group and control group were 84.18% (133/158) and 74.81% (98/131), 67.67% (517/764). The treatment group and the control group A and control group B respectively by x2 test analysis, P <0.05, with statistical significance. Conclusion: Preoperative induction chemotherapy for T1T2 stage oral mucosa squamous cell carcinoma has the effect of increasing survival rate. The effect of tumor diameter on the medium-term survival rate has statistical significance.