论文部分内容阅读
[目的]研究术前化疗能否提高手术切除率，降低局部复发率。［方法］104例头颈鳞癌病人分成试验组（58例）：术前化疗+手术+术后放疗组；对照组（46例）：手术+术后放疗，但不用术前化疗。手术方式为原发癌切除+颈淋巴结清扫术，用或不用肌皮瓣修复头颈部组织缺损。术后放疗剂量50Gy～60Gy。术前化疗用PFP方案即DDP＋5－Fu＋PYM。［结果］试验组部分缓解67.2%，微效17.2%。试验组和对照组3年局部复发率分别为27.6%、52．2％（P＜0.01）；但3年内远处转移率无差异，分别为34．5%、34．8%，中位生存期分别为23个月和22个月，3年生存率分别为65．5%和56．5%（P＞0.05）。［结论］术前新辅助化疗，可以缩小瘤体，提高手术切除率，减少局部复发。
[Objective] To study whether preoperative chemotherapy can improve the resection rate and reduce the local recurrence rate. [Methods] 104 cases of head and neck squamous cell carcinoma patients were divided into experimental group (58 cases): preoperative chemotherapy + surgery + postoperative radiotherapy group; control group (46 cases): surgery + postoperative radiotherapy, but no preoperative chemotherapy. The surgical approach was primary cancer resection + cervical lymph node dissection, with or without myocutaneous flaps to repair head and neck tissue defects. Postoperative radiation dose 50Gy ~ 60Gy. The PFP protocol for preoperative chemotherapy is DDP+5-Fu+PYM. [Results] The partial remission of the experimental group was 67.2% and the minor effect was 17.2%. The 3-year local recurrence rates in the experimental and control groups were 27.6% and 52.2%, respectively (P<0.01); however, there was no difference in the distant metastasis rates within 3 years, 34.5% and 34.8%, respectively. Periods were 23 months and 22 months, respectively. The 3-year survival rates were 65.5% and 56.5%, respectively (P>0.05). [Conclusion] Preoperative neoadjuvant chemotherapy can reduce the tumor volume, increase the resection rate and reduce the local recurrence.