Nakazawa M, Iwai S, Moriyama T, Kato I, Uekusa Y, Katagiri W, Takeuchi N, Matsumoto K, Sakuda M
Second Dept. of Oral and Maxillofacial Surgery, Osaka University, Faculty of Dentistry.
Gan To Kagaku Ryoho. 2001 Mar;28(3):337-43.
Preoperative chemotherapy should be effective against cancers and have few side effects that would prevent surgery. We investigated the histological effects and side effects of low- and high-dose CDDP chemotherapy against oral squamous cell carcinoma (SCC), and discuss the therapeutic benefits of each regimen. Thirty-six patients were divided into two groups as follows, in a non-randomized manner: A) low-dose CDDP (17 patients): CDDP 5 mg/m2/day + UFT 400 mg/day (day 1-5) (1 or 2 courses), B) high-dose CDDP (19 patients): CDDP 70-100 mg/m2/day (day 1) + peplomycin 5 mg/day (day 2-6) (1 or 2 courses). Curative surgery was conducted 1 week after protocol A or 2-3 weeks after protocol B. The histological antitumor effects were evaluated with Ohboshi & Shimosato's classification using surgical materials of primary tumors. In this classification, grade IIB, III and IV were as effective. Maximum histological effect was seen with grade IIB for regimen A and grade IV for regimen B. Four of 17 patients (23.5%) responded to regimen A and 13 of 19 patients (68.4%) to regimen B. Side effects, such as nausea, vomiting and myelosuppression, appeared with regimen B, but were seen little with regimen A. The 2-year survival rate was 93.3% with regimen A and 78.9% with regimen B. With regimen A, the 2-year survival rate of effective cases was 100% and that of ineffective cases was 91.7%. With regimen B, the rate was 92.3% and 50.0%, respectively. Effective cases showed good prognosis in both groups. The low-dose CDDP regimen was not so effective against primary tumors histologically, but the prognosis was good. The low-dose CDDP regimen appears to be useful for preoperative chemotherapy of oral SCC.
术前化疗应能有效对抗癌症，且副作用少，不至于妨碍手术。我们研究了低剂量和高剂量顺铂化疗对口腔鳞状细胞癌（SCC）的组织学效果及副作用，并探讨了每种方案的治疗益处。36例患者以非随机方式分为两组：A）低剂量顺铂组（17例患者）：顺铂5mg/m²/天+优福定400mg/天（第1 - 5天）（1或2个疗程），B）高剂量顺铂组（19例患者）：顺铂70 - 100mg/m²/天（第1天）+培普利欧霉素5mg/天（第2 - 6天）（1或2个疗程）。在方案A进行1周后或方案B进行2 - 3周后进行根治性手术。使用原发性肿瘤的手术材料，根据大星 & 下里的分类法评估组织学抗肿瘤效果。在此分类中，IIB级、III级和IV级均为有效。方案A的最大组织学效果见于IIB级，方案B见于IV级。17例患者中有4例（23.5%）对方案A有反应，19例患者中有13例（68.4%）对方案B有反应。方案B出现了恶心、呕吐和骨髓抑制等副作用，但方案A少见。方案A的2年生存率为93.3%，方案B为78.9%。对于方案A，有效病例的2年生存率为100%，无效病例为91.7%。对于方案B，该比率分别为92.3%和50.0%。两组中的有效病例预后均良好。低剂量顺铂方案在组织学上对原发性肿瘤的效果不太显著，但预后良好。低剂量顺铂方案似乎可用于口腔SCC的术前化疗。
