[Grade IV myelosuppression after induction chemotherapy of TPF on oral cancer: clinical analysis of 29 cases].

Purpose: 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.