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[口腔鳞状细胞癌:新辅助术前放化疗治疗结果及预后的回顾性分析]

[Oral squamous cell carcinoma Retrospective analysis of therapy results and prognosis by neoadjuvant, preoperative radio-chemotherapy].

作者信息

Reuther T, Posselt N K, Rabbels J, Kübler A C

机构信息

Klinik und Poliklinik für Zahnärztliche Chirurgie und für Mund-, Kiefer- und Plastische Gesichtschirurgie, Universität zu Köln, Köln, Germany.

出版信息

Mund Kiefer Gesichtschir. 2006 Jan;10(1):18-29. doi: 10.1007/s10006-005-0663-z.

Abstract

We investigated the charts of 129 patients treated for oral squamous cell carcinoma (SCC) in the Department of Oral and Maxillofacial Surgery, University of Cologne, between 1995 and 2004. Only patients treated preoperatively with combined radio-chemotherapy (carboplatin/39.6 Gy) were included. The purpose of the present study was to show the therapeutic outcome and the survival rates for this regimen. The mean age of the patients was 56.6 years. Male patients outnumbered female patients by 3:1. The floor of the mouth was the most common location (48.1%), and three out of four tumours (76.7%) had a G2 grading, while 82.9% were keratinized. Grade T4 was most the common (53.4%), and all patients were operated after preoperative treatment. In 82.2% of the cases, there were no tumour cells detectable microscopically (R0). In 34.1% there were viable tumour cells in the cervical lymph nodes, whereas in 66.7% these cells were found in the primary tumour despite preoperative treatment. A total of 38.8% of patients showed a recurrence of SCC. Mean survival was 4.8 years and 5 year survival 46.6%. The overall survival time of the disease was significantly influenced by pT (P=0.004), pN (P>0.001), R0 resections (P=0.0002), viable tumour cells in lymph node metastasis (P=0.0001), viable tumour cells in the primary (P=0.0004) and recurrence of the disease (P>0.001). In comparison to the current literature, no improvements in prognosis and survival of oral squamous cell carcinoma could be observed.

摘要

我们调查了1995年至2004年间在科隆大学口腔颌面外科接受口腔鳞状细胞癌(SCC)治疗的129例患者的病历。仅纳入术前接受联合放化疗(卡铂/39.6 Gy)的患者。本研究的目的是展示该治疗方案的治疗效果和生存率。患者的平均年龄为56.6岁。男性患者数量是女性患者的3倍。口底是最常见的发病部位(48.1%),四分之三的肿瘤(76.7%)为G2分级,82.9%为角化型。T4级最为常见(53.4%),所有患者在术前治疗后均接受了手术。在82.2%的病例中,显微镜下未检测到肿瘤细胞(R0)。34.1%的病例在颈部淋巴结中有存活的肿瘤细胞,而66.7%的病例尽管术前进行了治疗,但在原发肿瘤中发现了这些细胞。共有38.8%的患者出现SCC复发。平均生存期为4.8年,5年生存率为46.6%。疾病的总生存时间受到pT(P=0.004)、pN(P>0.001)、R0切除(P=0.0002)、淋巴结转移中存活的肿瘤细胞(P=0.0001)、原发灶中存活的肿瘤细胞(P=0.0004)和疾病复发(P>0.001)的显著影响。与当前文献相比,未观察到口腔鳞状细胞癌的预后和生存率有所改善。

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