Wadsley J C, Patel M, Tomlins C D C, Gildersleve J Q
Berkshire Cancer Centre and Department of Oral Surgery, Royal Berkshire Hospital, Reading, UK.
Br J Radiol. 2003 Jun;76(906):414-7. doi: 10.1259/bjr/20227256.
Carcinomas of the tongue and floor of mouth are relatively rare tumours, which may be treated using several modalities. We reviewed the results of iridium wire implants performed at the Royal Berkshire Hospital between 1994 and 2000. 24 patients had iridium wire implants as primary treatment for tongue and floor of mouth cancers. Four patients were treated after excision biopsy with close or involved margins. One patient was treated for a recurrence after surgery. The median age at treatment was 61 years. There were 18 men and 11 women. 21 patients had tumours of the tongue and eight of the floor of mouth. 13 had T1 tumours and 11 had T2a tumours. The median follow up was 42 months. The primary tumour was controlled in 22 of the 29 patients by the implant alone. Of the seven patients with local recurrence four were successfully salvaged with surgery. The acturarial 2 year survival rates were: overall survival 81%, disease specific survival 91%, local recurrence free survival 85% and nodal relapse free survival 76%. The recorded complication rate was low, one patient developing radionecrosis of the mandible at 7 years post implant. We believe these results show that brachytherapy remains a treatment option for patients with early tongue carcinoma with a high rate of local control and low toxicity.
舌癌和口底癌是相对罕见的肿瘤，可用多种方式进行治疗。我们回顾了1994年至2000年间在皇家伯克郡医院进行的铱丝植入治疗结果。24例患者接受了铱丝植入作为舌癌和口底癌的主要治疗方法。4例患者在切除活检后切缘紧邻或有肿瘤累及的情况下接受了治疗。1例患者接受了术后复发的治疗。治疗时的中位年龄为61岁。男性18例，女性11例。21例患者患有舌部肿瘤，8例患有口底肿瘤。13例为T1期肿瘤，11例为T2a期肿瘤。中位随访时间为42个月。29例患者中，仅通过植入治疗就使22例患者的原发肿瘤得到了控制。7例局部复发的患者中，有4例通过手术成功挽救。精算2年生存率为：总生存率81%，疾病特异性生存率91%，无局部复发生存率85%，无淋巴结复发率76%。记录的并发症发生率较低，1例患者在植入后7年发生下颌骨放射性坏死。我们认为这些结果表明，近距离放射治疗仍然是早期舌癌患者的一种治疗选择，局部控制率高且毒性低。
