Department of Dentistry and Oral Surgery, Fukushima Medical University, School of Medicine, Fukushima, Japan.
Department of Dentistry and Oral Surgery, Fukushima Medical University, School of Medicine, Fukushima, Japan.
Int J Oral Maxillofac Surg. 2020 Aug;49(8):984-992. doi: 10.1016/j.ijom.2020.01.024. Epub 2020 Feb 16.
The objectives of this study were to evaluate survival in 141 patients with stage II-IV oral squamous cell carcinoma (OSCC) treated with preoperative intra-arterial chemotherapy with docetaxel, cisplatin, and peplomycin combined with intravenous chemotherapy using 5-fluorouracil (IADCPIVF) via the superficial temporal artery, and to clarify the prognostic factors. The study population included 59 patients with stage II OSCC, 34 with stage III, and 48 with stage IV. After IADCPIVF, 139 patients underwent surgery; minimally invasive surgeries (MIS) including excisional biopsy were performed on 96 patients with a remarkably good response to IADCPIVF. The primary tumour response rate was 99.3% (complete response rate 56.7%, good partial response rate 17.0%, fair partial response rate 25.5%). Additionally, there were no serious adverse events associated with IADCPIVF. The 5-year overall survival rate was 74.6% (stage II 83.6%, stage III 72.7%, stage IV 64.8%). In the multivariate analysis of survival, T classification and clinical tumour response were significant prognostic factors. Eight (8.3%) of the patients who received MIS had primary recurrence and six were salvaged. In conclusion, IADCPIVF is safe and efficacious for treating OSCC, and MIS could reduce the extent of primary tumour resection in the case of a remarkably good response.
本研究的目的是评估 141 例接受术前经颞浅动脉动脉内化疗（紫杉醇、顺铂和培洛霉素联合静脉化疗氟尿嘧啶）治疗的 II-IV 期口腔鳞状细胞癌（OSCC）患者的生存情况，并阐明预后因素。研究人群包括 59 例 II 期 OSCC 患者、34 例 III 期和 48 例 IV 期患者。IADCPIVF 后，139 例患者接受手术；96 例对 IADCPIVF 反应良好的患者行微创手术（MIS），包括切除术活检。原发肿瘤反应率为 99.3%（完全缓解率 56.7%，部分缓解良好率 17.0%，部分缓解中等率 25.5%）。此外，IADCPIVF 无严重不良事件。5 年总生存率为 74.6%（II 期 83.6%，III 期 72.7%，IV 期 64.8%）。在生存的多因素分析中，T 分类和临床肿瘤反应是重要的预后因素。8 例（8.3%）接受 MIS 的患者出现原发复发，6 例经挽救性治疗。结论：IADCPIVF 治疗 OSCC 安全有效，MIS 可在反应良好的情况下减少原发肿瘤切除范围。
