口腔扁平上皮癌症例におけるinduction chemotherapyの意義に関する臨床病理学的研究

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The purpose of this study was to assess the value of induction chemotherapy based on clinicopathologic malignancy grade in systematic oral cancer treatment. Onehundred and eight patients with oral squamous cell carcinomas were surgically operated on after induction chemotherapy based on both the clinicopathologic malignancy grade and the effect of induction chemotherapy. These cases were clinicopathologically examined to determine the value of induction chemotherapy. The following results were obtained:<BR>The clinical response rate of induction chemotherapy was 63.0% and the histologic response rate was 54. 6%. Regarding the relationship between the histologic effect and the clinicopathologic malignancy grade, as malignancy grade became higher the histologic response tended to diminish. Regarding the relationship between the histologic response and nodal metastasis, in the good histologic response group (GradeIII/IV) there were few primary metastases and no secondary metastases. It was suggested that induction chemotherapy which showed good anticancer efficacy at t4he primary region may also have a good effect on metastatic lymph nodes. Regarding the relationship between the histologic effect of induction chemotherapy and prognosis, the better the histologic response, the better was the prognosis. There was a statistically significant difference in prognosis between the histologic responder group (Grades II B/III/IV) and the histologic nonresponder group (Grades I/II A). These facts suggested that the histologic effects of induction chemotherapy may be one of the important factors determining prognosis. For survival rate by the clinicopathologic malignancy grade, the higher the malignancy grade, the lower was the survival rate. For survival rate by the clinical stage, the more advanced the stage, the lower was the survival rate. In particular, there was a statistically significant difference in survival rate between stage El and the other stages. The total five years cumulative survival rate was 80.8%, which was favorable. This suggested that in systematic oral cancer treatment, induction chemotherapy and surgical therapy based on the clinicopathologic malignancy grade may help to improve the prognosis of oral cancer.<BR>In conclusion, induction chemotherapy was less effective for advanced and high malignancy grade case. Whereas it was more effective for the other cases. The application of both induction chemotherapy based on the clinicopathologic malignancy grade and surgery based on the effects of induction chemotherapy should help to improve chances for radical cure of oral cancer.

口腔扁平上皮癌症例におけるinduction chemotherapyの意義に関する臨床病理学的研究

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