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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。
Objective To prospectively study the effects of large and small doses of teniposide (VM2 6) combined with cisplatin (CDDP) and bleomycin (PYM) on the clinical and chemotherapeutic effects of oral and maxillofacial squamous cell carcinoma. Methods Totally 65 patients were included in the study and were randomly divided into two groups (33 and 32 cases). The patients were treated with high-dose VM2 6 (32 0mg) chemotherapy and low-dose VM2 6 (15 8mg) chemotherapy (PTP2 ) Treatment, observation, evaluation of their respective short-term chemotherapy and toxicity. Results A total of 33 patients undergoing chemotherapy with high-dose VM2 6 regimen completed 38 cycles of chemotherapy with a total effective rate of PR 82.8% (27/33). Another 32 patients underwent chemotherapy with low-dose VM2 6 regimen, A total of 36 cycles of chemotherapy were completed, with an effective rate of 81.25%. There was no significant difference in the chemotherapy effect between the two groups (P> 0.05). There was a significant difference in the side effects of the blood between the two groups. In the high-dose VM2 6 group The myelosuppression rate (1 ~ 4 grade) reached 48.48%, which was significantly higher than that of low dose VM2 6 group (25.0%, P <0.01). Conclusions In view of the effectiveness of low dose VM2 6 chemotherapy (PTP2) in the treatment of squamous cell carcinoma of oral and maxillofacial region and its relatively mild adverse reactions, low dose VM2 6 combined with CDDP and PYM chemotherapy can be widely used in clinical chemotherapy of oral squamous cell carcinoma Program.