Urashima Yusuke, Nakamura Katsumasa, Shioyama Yoshiyuki, Sasaki Tomonari, Ohga Saiji, Toba Takashi, Kunitake Naonobu, Chikui Tooru, Kawazu Toshiyuki, Yamada Tomomi, Terashima Hiromi, Honda Hiroshi
Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan.
Jpn J Clin Oncol. 2006 Nov;36(11):681-7. doi: 10.1093/jjco/hyl099. Epub 2006 Oct 4.
To assess tongue atrophy and long-term functional outcome of mobile tongue cancer patients after interstitial radiotherapy.
Of 493 patients whose squamous cell carcinoma of the mobile tongue had been treated with low dose rate brachytherapy, there were 57 patients evaluated between July 2002 and April 2004 whose tongue had not been modified by surgical procedures and who had no primary recurrence. The median time from treatment to evaluation was 96 months (range: 9-214 months). Almost all of the patients belonged to the early stage tongue cancer (T1/T2/T3/T4=30:24:3:0), and all had received interstitial radiotherapy with a single-plane implant. To evaluate the deformity of the tongue, we used a grading system that classified the atrophic changes of the tongue into four categories (G0-G3).
Thirty-nine patients (70%) showed mild tongue hemiatrophy (G1 or G2) in the irradiated side. However, no patients showed severe atrophy where the tongue cannot be made to protrude beyond the incisors (G3). The length of time after brachytherapy was >72 months and the age of the patients at brachytherapy had the same statistical significance (P=0.0366). As for functional outcome, understandability of speech and a normal diet were preserved for almost all patients.
The progression of atrophic change in the irradiated tongue occurred over a long term after brachytherapy. However, most patients could maintain their activities of daily life without severe restriction.
评估可动性舌癌患者间质放疗后的舌萎缩情况及长期功能结局。
在493例接受低剂量率近距离放疗治疗可动性舌鳞状细胞癌的患者中，有57例于2002年7月至2004年4月期间接受评估，这些患者的舌未经过手术改变且无原发灶复发。从治疗到评估的中位时间为96个月（范围：9 - 214个月）。几乎所有患者均属于早期舌癌（T1/T2/T3/T4 = 30:24:3:0），且均接受了单平面植入的间质放疗。为评估舌的畸形情况，我们使用了一种分级系统，将舌的萎缩变化分为四类（G0 - G3）。
39例患者（70%）在放疗侧出现轻度舌半侧萎缩（G1或G2）。然而，没有患者出现舌无法伸出切牙之外的严重萎缩（G3）。近距离放疗后时间>72个月以及近距离放疗时患者年龄具有相同的统计学意义（P = 0.0366）。至于功能结局，几乎所有患者的言语可懂度和正常饮食得以保留。
近距离放疗后，放疗侧舌萎缩变化的进展发生在长期过程中。然而，大多数患者能够在没有严重限制的情况下维持其日常生活活动。
