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目的探讨术前多西他赛联合顺铂和5-氟尿嘧啶(DPF)诱导化疗在局部晚期舌鳞癌的耐受性/不良反应和近期疗效。方法将108例患者术前诊断为局部晚期舌鳞癌患者随机分成DPF组(54例)采用DPF方案诱导化疗,和PF组(54例)采用顺铂+5-氟尿嘧啶(PF)诱导化疗。以治疗前MR及2程诱导化疗结束后3周的MR对原发灶的变化进行比较判断。采用SPSS 16.0统计软件进行数据处理,两组资料组间构成比及计数资料采用χ2检验,计量资料采用t检验,P<0.05表示差异有统计学意义。结果 DPF组和PF组每组54例患者,均按计划完成治疗。DPF组的患者诱导化疗有效率显著高于PF组(70.37%vs.51.85%,χ2=3.89,P=0.04)。与PF组相互比较,DPF组的患者出现Ⅲ+Ⅳ级的白细胞减少(53.70%vs.18.52%,P=0.01)、Ⅰ+Ⅱ级口腔黏膜炎(38.89%vs.7.41%,P<0.01)、Ⅰ+Ⅱ级体质量减轻(74.07%vs.31.48%,P<0.01)和Ⅱ级脱发(100.00%vs.37.04%,P<0.01)均较高,但通过积极对症处理后好转。结论在局部晚期舌癌患者中采用DPF方案进行术前诱导化疗较PF方案的近期疗效好,患者耐受性好,但不良反应稍高,应当积极对症处理。
Objective To investigate the tolerance / adverse reactions and short-term effects of preoperative docetaxel combined with cisplatin and 5-fluorouracil (DPF) induced chemotherapy in locally advanced tongue squamous cell carcinoma. Methods 108 patients with locally advanced tongue squamous cell carcinoma were randomly divided into DPF group (n = 54) and chemotherapy with DPF regimen (n = 54), and cisplatin plus 5-fluorouracil (PF) -induced chemotherapy in PF group. MR before treatment and 2-way induction of chemotherapy after 3 weeks of MR on the changes of the primary lesion to judge. SPSS 16.0 statistical software was used to process the data. The composition ratio and count data of two data sets were analyzed by Chi-square test. The measurement data were analyzed by t-test. P <0.05 was considered statistically significant. Results Each group of 54 patients in DPF group and PF group were treated according to plan. The efficiency of induction chemotherapy in DPF group was significantly higher than that in PF group (70.37% vs.51.85%, χ2 = 3.89, P = 0.04). Compared with the PF group, patients in the DPF group had grade Ⅲ + Ⅳ leukopenia (53.70% vs.18.52%, P = 0.01), grade Ⅰ + Ⅱ oral mucositis (38.89% vs.7.41%, P <0.01) (74.07% vs.31.48%, P <0.01) and grade Ⅱ alopecia (100.00% vs.37.04%, P <0.01), but the symptoms were improved after active symptomatic treatment. Conclusions The preoperative induction chemotherapy with DPF in patients with locally advanced tongue cancer has a better short-term curative effect than PF. Patients are well tolerated, but the adverse reactions are slightly higher and should be symptomatically treated.