Fan Lina, Hu Xuegang, Lin Shihan, Zhou Wentu, Fu Sheng, Lv Hongbing
Department of Oral and Maxillofacial Surgery, Fuzhou General Hospital of Nanjing Command, PLA, Fuzhou, China.
School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China.
Oncotarget. 2017 Apr 21;8(43):75557-75567. doi: 10.18632/oncotarget.17363. eCollection 2017 Sep 26.
The objectives of this study were to assess the clinical effects of an integrated program consisting of concurrent preoperative combined paclitaxel and nedaplatin chemotherapy and three-dimensional conformal radiotherapy followed by surgery intended to cure oral squamous cell carcinoma and to determine whether this integrated program is feasible and effective with respect to the treatment of oral squamous cell carcinoma.
A total of 104 biopsy-confirmed patients who presented with oral squamous cell carcinoma for the first time were included in this study. Concurrent preoperative combined paclitaxel and nedaplatin chemotherapy and three-dimensional conformal radiotherapy were administered to these patients. The most common treatment regimen consisted of infusions of paclitaxel (135-175 mg/m/day), infusions of nedaplatin (150 mg; 80-100 mg/m/day), and irradiation at doses ranging from 1.5 Gy twice daily to 30-40 Gy over 3-4 weeks. The clinical variables evaluated herein included the local recurrence rate, distant metastasis rate, postoperative survival rate, and degree of mouth opening restriction.
The median follow-up time for surviving patients was 60 months, and the median time to progression for all patients was 57.69 months (95% confidence interval, 56.09 to 59.29 months, and the 3-year disease-free survival probability was 97.11%). The effectiveness rate of the integrated program was 98.08%, and the surgery resection rate was 100%. Only a few postoperative adverse reactions were observed. The local recurrence and distant metastasis rates were 1.92% (2 patients) and 2.88% (3 patients), respectively. The titanium rejection and infection reaction rate that led to restriction of mouth opening was only 2.88% (3 patients). Finally, the 5-year post-surgery survival rate was 91.35% (95 patients).
Preoperative combined paclitaxel and nedaplatin chemotherapy and three-dimensional conformal radiotherapy have significant clinical effects leading to positive anti-tumor results in patients with oral squamous cell carcinoma. These treatments also increase the likelihood that patients will undergo successful surgical treatment. The integrated program described herein can increase long-term survival and surgery resection rates and is associated with only a limited number of adverse reactions.
本研究的目的是评估由术前同步紫杉醇和顺铂联合化疗及三维适形放疗组成、随后进行手术的综合方案对口腔鳞状细胞癌的临床疗效，并确定该综合方案在治疗口腔鳞状细胞癌方面是否可行且有效。
本研究纳入了104例首次经活检确诊为口腔鳞状细胞癌的患者。对这些患者进行术前同步紫杉醇和顺铂联合化疗及三维适形放疗。最常见的治疗方案包括紫杉醇输注（135 - 175mg/m²/天）、奈达铂输注（150mg；80 - 100mg/m²/天），以及在3 - 4周内每天两次1.5Gy至30 - 40Gy的照射。本文评估的临床变量包括局部复发率、远处转移率、术后生存率和张口受限程度。
存活患者的中位随访时间为60个月，所有患者的中位疾病进展时间为57.69个月（95%置信区间，56.09至59.29个月），3年无病生存概率为97.11%。综合方案的有效率为98.08%，手术切除率为100%。仅观察到少数术后不良反应。局部复发率和远处转移率分别为1.92%（2例患者）和2.88%（3例患者）。导致张口受限的钛排斥和感染反应率仅为2.88%（3例患者）。最后，术后5年生存率为91.35%（95例患者）。
术前紫杉醇和顺铂联合化疗及三维适形放疗对口腔鳞状细胞癌患者具有显著的临床疗效，可产生积极的抗肿瘤效果。这些治疗方法还增加了患者成功接受手术治疗的可能性。本文所述的综合方案可提高长期生存率和手术切除率，且不良反应数量有限。
