不同剂量替尼泊苷联合化疗方案治疗口腔鳞癌的前瞻性研究

目的　前瞻性研究大、小剂量的替尼泊苷 (VM2 6)分别联合顺铂 (CDDP)和平阳霉素(PYM)对口腔颌面部鳞状细胞癌患者临床化疗效果和毒副作用。方法　共有 6 5例患者纳入研究 ,随机分为 2组 (33例和 32例 ) ,分别进行高剂量VM2 6(32 0mg)化疗方案 (PTP1)和低剂量VM2 6(15 8mg)化疗方案 (PTP2 )的治疗 ,观察、评价各自短期化疗效果和毒副反应。结果　接受高剂量VM2 6方案化疗患者 33例 ,共完成 38周期的化疗 ,化疗总有效率 (PR CR)为 81 82 % (2 7/33) ;另外32例接受低剂量VM2 6方案化疗 ,共完成 36个周期化疗 ,有效率为 81 2 5 % ,两组间化疗效果差异无显著性 (P >0 0 5 ) ;两组间患者血液毒副反应差别明显 ,高剂量VM2 6化疗组的骨髓抑制率 (1～ 4级 )达到 4 8 4 8% ,明显高于低剂量VM2 6组 (2 5 0 0 % ,P <0 0 1)。结论　鉴于低剂量VM2 6化疗方案(PTP2 )治疗口腔颌面部鳞癌的有效率及相对较轻的不良反应 ,可在口腔鳞癌临床化疗中推广应用低剂量VM2 6联合CDDP、PYM组成的化疗方案。

Chemotherapy with higher or lower dose of teniposide combined with cisplatin and pingyangmycin for oral squamous cell carcinoma

Objective To compare the clinical efficacy and toxicity of teniposide (VM 26 ) of higher dose with those of lower dose,both combined with cisplatin (CDDP) and pingyangmycin (PYM),in the treatment of patients with squamous cell carcinoma of oral and maxillofacial region (SCCOMR). Methods Sixty-five patients with SCCOMR entered into this study prospectively. Thirty-three patients were treated with higher dose of VM 26 (total dose was 320 mg) combined with CDDP and PYM (PTP1),the other thirty-two patients were treated with lower dose (total dose was 158 mg) of VM 26 combined with CDDP and PYM (PTP2). Results Thirty-three patients received a total of 38 cycles of PTP1. The overall response rate was 81.82% (27/33). Thirty-two patients received a total of 36 cycles of PTP2 and showed overall response rate by 81.25% (26/32). There was no significant difference between PTP1 and PTP2 groups in response rate ( P >0.05). But the blood toxicity was more severe in PTP1 group than in PTP2 group ( P <0.01). Bone marrow depression rate (1-4 stage) was 48.48% in PTP1 group versus 25.00% in the other group. Conclusions A high response rate of 81.25% and relatively slighter adverse events could be obtained for lower dose of VM 26 combined with CDDP and PYM (PTP2). So,the chemotherapy schedule,PTP2,a novel teniposide based regimen in SCCOMR could be employed and spread in clinical practice.