Tohnai Iwai, Hayashi Yasushi, Mitsudo Kenji, Shigetomi Toshio, Ueda Minoru, Ishigaki Takeo
Department of Maxillofacial Surgery, Nagoya University Graduate School of Medicine, Japan.
Oncology. 2002;62(3):234-40. doi: 10.1159/000059571.
The purpose of this study was to evaluate the clinical efficacy, histopathological efficacy, and response to preoperative thermochemoradiotherapy for N(3) cervical lymph node metastases of oral cancer.
Preoperative thermochemoradiotherapy was performed in 8 patients with oral cancer and N(3) cervical lymph node metastasis. These patients underwent four-weekly sessions of hyperthermia, combined with radiotherapy (40 Gy) as well as chemotherapy with cisplatin (CDDP; 100 mg/m2), all prior to surgery. Radical neck dissection was performed 4 weeks after completion of preoperative thermochemoradiotherapy.
The preoperative treatment of cervical lymph node metastases yielded a partial response in 6 patients, while 2 patients demonstrated no change. Histopathologically, grade III was detected in 1, grade IIb in 4 and grade IIa in 3 patients after surgery, according to the criteria of Shimosato. The follow-up period ranged from 13 to 64 months (mean 34). Of the 8 patients, 2 died (1 of lymph node metastasis and 1 had metastasis to a distant site), and 6 patients were alive at the last follow-up, with the longest postoperative disease-free survival being 63 months. The 5-year cumulative survival rate was 70.0%.
These results indicate that preoperative thermochemoradiotherapy is a promising modality for patients with N(3) cervical lymph node metastasis of oral cancer.
本研究旨在评估术前热化疗放疗对口腔癌N(3)期颈部淋巴结转移的临床疗效、组织病理学疗效及反应。
对8例口腔癌伴N(3)期颈部淋巴结转移患者进行术前热化疗放疗。这些患者在手术前每周接受4次热疗，同时联合放疗（40 Gy）以及顺铂（CDDP；100 mg/m2）化疗。术前热化疗放疗完成4周后进行根治性颈清扫术。
术前对颈部淋巴结转移的治疗使6例患者出现部分缓解，2例患者无变化。根据下里佐的标准，术后病理检查发现1例为Ⅲ级，4例为Ⅱb级，3例为Ⅱa级。随访时间为13至64个月（平均34个月）。8例患者中，2例死亡（1例死于淋巴结转移，1例远处转移），6例患者在最后一次随访时存活，术后最长无病生存期为63个月。5年累积生存率为70.0%。
这些结果表明，术前热化疗放疗对口腔癌N(3)期颈部淋巴结转移患者是一种有前景的治疗方式。
