Silverman M K, Kopf A W, Gladstein A H, Bart R S, Grin C M, Levenstein M J
Department of Dermatology, New York University School of Medicine, NY.
J Dermatol Surg Oncol. 1992 Jul;18(7):549-54. doi: 10.1111/j.1524-4725.1992.tb03508.x.
This is the fourth report in a series that reviews the experience in the Skin and Cancer Unit, from 1955 through 1982, with the treatment of basal cell carcinomas (BCCs). It concerns 862 primary (previously untreated) BCCs irradiated by a "standardized" x-ray therapy schedule. The overall 5-year recurrence rate for these lesions, as determined by the modified life-table method, was 7.4%. This rate was not significantly different from that experienced with 211 recurrent (previously treated) BCCs with a re-recurrence rate of 9.5% (P = .552). For the primary BCCs, multivariate analysis showed that increasing BCC diameter was the only independent risk factor for high recurrence rates (P = .003). The patient's age or sex, the duration of the BCC, the anatomic site of the BCC, or time-span treated (1955-1963, 1964-1972, 1973-1982) did not significantly affect the recurrence rate. Additional analysis showed that BCCs on the head less than 10 mm in diameter had a 5-year recurrence rate of 4.4% whereas those 10 mm or greater in diameter had a rate of 9.5%. Lastly, the proportion of recurrence-free treatment sites with a good or excellent long-term cosmetic outcome after x-ray therapy (63%) was lower than previous reports in this series with curettage-electrodesiccation (91%) and surgical excision (84%). Thus, if the long-term cosmetic outcome after treatment is not an overriding concern to the patient, x-ray therapy is an effective modality for many primary and recurrent BCCs.
这是一系列回顾1955年至1982年皮肤与癌症科室治疗基底细胞癌（BCC）经验的报告中的第四篇。它涉及862例接受“标准化”X线治疗方案照射的原发性（未经治疗）BCC。采用改良寿命表法确定，这些病变的总体5年复发率为7.4%。该比率与211例复发性（先前接受过治疗）BCC的复发率（9.5%）相比无显著差异（P = 0.552）。对于原发性BCC，多变量分析显示，BCC直径增大是高复发率的唯一独立危险因素（P = 0.003）。患者的年龄或性别、BCC的病程、BCC的解剖部位或治疗时间跨度（1955 - 1963年、1964 - 1972年、1973 - 1982年）对复发率均无显著影响。进一步分析表明，直径小于10 mm的头部BCC的5年复发率为4.4%，而直径大于或等于10 mm的复发率为9.5%。最后，X线治疗后长期美容效果良好或极佳的无复发治疗部位比例（63%）低于本系列先前关于刮除 - 电干燥法（91%）和手术切除（84%）的报告。因此，如果治疗后的长期美容效果不是患者首要关注的问题，那么对于许多原发性和复发性BCC，X线治疗是一种有效的治疗方式。
