Al-Rajhi Nasser, Saleem Mohammad, Al-Amro Abdullah S, El-Enbaby Ashraf M, El-Husseiny Gamal A, Mahasin Zeyad Z, Taibah Kalid M, Al-Zahrani Ali M
Department of Radiation Oncology, King Faisal Specialist Hospital and Research Centre, MBC 34, PO Box 3354, Riyadh 11211, Kingdom of Saudi Arabia.
Saudi Med J. 2002 Sep;23(9):1095-8.
To evaluate the outcome of radical treatment for patients with stage IV squamous cell carcinoma of the oral cavity.
Using head and neck tumor database, 57 patients with stage IV non-metastatic invasive squamous cell carcinoma of the oral cavity treated with curative intent at King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia, between July 1992 and June 1998, were identified and retrospectively reviewed.
Our cohort of patients consisted of 33 males and 24 females, with a median age of 65 years. The primary sites were alveolus (26), tongue (22), buccal mucosa (6), floor of mouth (2) and retromolar trigone (one). Definitive radiotherapy was used in 7 patients, surgery in 17 and combined modality in 33. With a median follow-up for surviving patients of 53-months, the actuarial 5-year overall survival and relapse free survival was 20% and 14%. Tumors arising from the alveolus showed a better outcome as compared to the rest of oral cavity sites with an overall survival and relapse free survival of 32% and 26% compared to 8% and 4% (p value=0.0057 and 0.0038).
Advanced oral cavity tumors are aggressive neoplasms with a poor outcome to conventional treatment modalities. New approaches like neoadjuvant or concurrent chemoradiotherapy with or without surgery need to be considered and evaluated in prospective studies.
评估口腔IV期鳞状细胞癌患者的根治性治疗效果。
利用头颈肿瘤数据库，确定并回顾性分析了1992年7月至1998年6月期间在沙特阿拉伯利雅得法赫德国王专科医院和研究中心接受根治性治疗的57例IV期非转移性口腔浸润性鳞状细胞癌患者。
我们的患者队列包括33名男性和24名女性，中位年龄为65岁。原发部位为牙槽（26例）、舌（22例）、颊黏膜（6例）、口底（2例）和磨牙后三角区（1例）。7例患者采用了根治性放疗，17例采用手术治疗，33例采用综合治疗。存活患者的中位随访时间为53个月，5年总生存率和无复发生存率分别为20%和14%。与口腔其他部位相比，牙槽来源的肿瘤预后较好，总生存率和无复发生存率分别为32%和26%，而其他部位为8%和4%（p值分别为0.0057和0.0038）。
晚期口腔肿瘤是侵袭性肿瘤，对传统治疗方式预后较差。需要在前瞻性研究中考虑并评估新的方法，如新辅助或同步放化疗联合或不联合手术。
