Clinical Evaluation of Combination Chemotherapy Using Cis-Platinum and Bleomycin in Advanced Squamous Cell Carcinoma of the Oral Cavity

口腔鱗狀上皮細胞癌施以Cis-Platinum及Bleomycin併用療法其臨床效果之研討

陳中和(Chung-Ho Chen)

《The Kaohsiung Journal of Medical Sciences》 2卷4期 (1986/04) Pp. 248-255

https://doi.org/10.6452/KJMS.198604.0248

摘要

對20位口腔鱗狀上皮細胞癌之病例施行cis-platinum及bleomycin 併用療法。投藥方法是第一、二、四、五天給予bleomycin 15mg/m2/day，動脈注射，第三天給予cis-platinum 50 mg/m2，靜脈點滴注射，第六、七兩天停藥。如此反覆共三星期。並在第21天評估其治療成績。在20個病例中，完全反應有4例，部份反應有9例，兩者合計之主要反應率為65%。在此種化學治療前曾接受外科手術切除病灶，或是曾接受放射線照射治療的8例，其化學治療主要的反應率為50％。而在化學藥物治療前，未曾接受其他治療的有12例，其化學治療的主要反應率為75%。至於副作用：發生脫髮現象的有6例，噁心嘔吐的有8例，口腔黏膜潰瘍發炎的有11例。在血液學方面：白血球數量少於3000/cmm的有4例，血小板數少於10×104/cmm的有3例，血紅素值降低2g/dl的有16例，其中有8例其血紅素值降到10g/dl以下。所有的病例皆無腎臟功能障碍發生。在整個治療過程中，有一例因其他原因而死亡。本療法作為進行性而不適於外科手術的口腔鱗狀上皮細胞癌，且未曾接受任何外科手術或放射線治療的病例，其效果較顯著。

並列摘要

Twenty patients with advanced unresectable oral cancer were given intravenous cis-platinum (50mg/m2 per one course after prehydration with mannitol diuresis on day 3)and intraarterial infusion of bleomycin(15mg/m2/day on days 1,2,4,and 5), repeated for a total of 3 courses. Immediately following completion of the three courses, radiotherapy was given, using standard doses(6000 rads) and fractions. Patients were evaluated for response on day 21 before radiation. There were four CR and nine PR(50% reduction of all measurable disease), for a major response rate of 65%. The major response rates of eight previously treated cases and twelve previously untreated patients were 50% and 75% respectively. The side effects of this chemotherapeutic regimen in 20 patients were: alopecia (6 cases), nausea and vomiting (8 cases), mucositis (11 cases);WBC count less than 3000/cmm (4 cases);platelet less than 10×104/cmm(3 cases), Hgb decrease more than 2g/dl (16 cases,including 8 cases with Hgb less than 10g/dl). No nephrotoxicity was found and one patient died during the chemotherapeutic treatment course. This regimen, when given as initial treatment for the advanced unresectable oral cancers, appears very effective in reducing tumor bulk, and may also have some positive effects in previously treated patients.

並列關鍵字

squamous cell carcinoma ； cis-platinum ； bleomycin