Lin Chun-Shu, Jen Yee-Min, Cheng Ming-Fang, Lin Yaoh-Shiang, Su Wan-Fu, Hwang Jing-Min, Chang Li-Ping, Chao Hsing-Lung, Liu Dai-Wei, Lin Hon-Yi, Shum Weng-Yoon
Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center, 325 Section 2 Cheng-Kong Rd., Nei-Hu, Taipei, Taiwan, Republic of China.
Head Neck. 2006 Feb;28(2):150-7. doi: 10.1002/hed.20303.
In our clinical practice, we have observed a high incidence of locoregional failure in squamous cell carcinoma (SCC) of the buccal mucosa. We analyze our treatment results of this cancer and compare these results with those in the literature. We intend to define the pattern and incidence of failure of buccal cancer and provide information for the design of a better multimodality treatment.
During the period from 1983 through 2003, 121 previously untreated patients with M0 stage SCC of the buccal mucosa were treated with a curative intent at our hospital. Twenty-seven patients received surgery alone, 36 had radiotherapy alone, and 58 underwent surgery plus postoperative radiotherapy.
The 5-year locoregional control, overall survival, and cause-specific survival rates for all patients were 36.3%, 34.3%, and 36.9%, respectively. The locoregional recurrence rate was 57% for all patients, with 80% occurring in the primary site alone. Patients with T1-2N0 disease who received surgery alone still had a high local recurrence incidence of 41%. For patients with locally advanced disease, surgery plus postoperative radiotherapy achieved better overall survival and locoregional control rates than surgery alone or radiotherapy alone. T classification was the only prognostic factor affecting locoregional control and survival in the surgery alone group, whereas N classification and skin invasion predicted a poorer survival for the surgery plus postoperative radiotherapy group.
SCC of the buccal mucosa is an aggressive cancer with a high locoregional failure rate even in patients with T1-2N0 disease. Possible reasons include inadequate treatment and an intrinsically aggressive nature. Postoperative radiotherapy has resulted in a better locoregional control rate for patients with T3-4 or N+ disease and should also be considered for patients with T1-2N0 disease for whom adjuvant therapy after radical surgery currently is not recommended by most guidelines.
在我们的临床实践中，我们观察到颊黏膜鳞状细胞癌（SCC）的局部区域复发率很高。我们分析了这种癌症的治疗结果，并将这些结果与文献中的结果进行比较。我们旨在确定颊癌的复发模式和发生率，并为设计更好的多模式治疗提供信息。
在1983年至2003年期间，我院对121例未经治疗的M0期颊黏膜SCC患者进行了根治性治疗。27例患者仅接受手术治疗，36例仅接受放射治疗，58例接受手术加术后放射治疗。
所有患者的5年局部区域控制率、总生存率和疾病特异性生存率分别为36.3%、34.3%和36.9%。所有患者的局部区域复发率为57%，其中80%仅发生在原发部位。仅接受手术治疗的T1-2N0期患者局部复发率仍高达41%。对于局部晚期疾病患者，手术加术后放射治疗在总生存率和局部区域控制率方面比单纯手术或单纯放射治疗更好。T分期是影响单纯手术组局部区域控制和生存的唯一预后因素，而N分期和皮肤侵犯则预示着手术加术后放射治疗组的生存较差。
颊黏膜SCC是一种侵袭性癌症，即使是T1-2N0期患者局部区域复发率也很高。可能的原因包括治疗不充分和其固有的侵袭性。术后放射治疗使T3-4或N+疾病患者的局部区域控制率更好，对于目前大多数指南不建议进行根治性手术后辅助治疗的T1-2N0期患者也应考虑。
