title: [Grade IV myelosuppression after induction chemotherapy of TPF on oral cancer: clinical analysis of 29 cases].
abstract: OBJECTIVE
  To observe and evaluate the clinical features and treatment strategies of IV myelosuppression after induction chemotherapy of oral mucosa squamous cell carcinoma under conventional dosage.
  
  
  METHODS
  Twenty-nine patients of oral mucosa squamous cell carcinoma pathologically diagnosed between 2006 and 2012 were enrolled into this study. The patients received induction chemotherapy with docetaxel-cisplatin-5-fluorouracil (TPF) and suffered from grade IV myelosuppression. Regulations and treatment strategies of the bone marrow myelosuppression were analyzed, retrospectively.
  
  
  RESULTS
  Twenty-nine cases had bone marrow suppression 9-14 days after induction chemotherapy, and the median time was 10 days, with a "U"-shaped fluctuation pattern. There were 26 cases with colony-stimulating factor(CSF) therapy completing treatment according to the schedule and 2 cases were required to radiotherapy because of unsatisfied effect of CSF therapy. One case died and the death rate after chemotherapy was 0.68% in this group.
  
  
  CONCLUSIONS
  The incidence of grade IV myelosuppression is normal and fatal. This study shows the starting time of the "U"-shaped fluctuation and the necessaries of adding CSF therapy at the same time. The emergency treatment of myelosuppression should be used including single disinfected ward mouthwash and therapy of CSF drug.
authors.affiliation: Department of Oral and Maxillofacial-Head & Neck Surgery, Anhui Provincial Hospital, Anhui Medical University. Hefei 230001, Anhui Province, China. E-mail:jinjing0124@sina.com.
authors.forename: Jing
authors.initials: J
authors.lastname: Jin
authors.forename: Mao-chang
authors.initials: MC
authors.lastname: Ye
authors.forename: Lai-ping
authors.initials: LP
authors.lastname: Wang
authors.forename: Rong-xin
authors.initials: RX
authors.lastname: Li
authors.forename: Yu
authors.initials: Y
authors.lastname: Zhou
authors.forename: Yi
authors.initials: Y
authors.lastname: Wang
authors.forename: Wei-zheng
authors.initials: WZ
authors.lastname: Zhu
authors.forename: Yan
authors.initials: Y
authors.lastname: Zuo
authors.forename: Shou-hong
authors.initials: SH
authors.lastname: Liu
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols; D002294:Carcinoma, Squamous Cell; D002945:Cisplatin; D000077143:Docetaxel; D005472:Fluorouracil; D006801:Humans; D060828:Induction Chemotherapy; D009061:Mouth Mucosa; D009062:Mouth Neoplasms; D012189:Retrospective Studies; D043823:Taxoids
chemical_list: D043823:Taxoids; D000077143:Docetaxel; D002945:Cisplatin; D005472:Fluorouracil