[舌癌综合治疗（手术及术后放疗）的结果与预后因素]

[The results of combined treatment (surgery and postoperative radiotherapy) for tongue cancer and prognostic factors].

作者信息

Karadeniz Ahmet, Saynak Mert, Kadehci Züleyha, Fayda Merdan, Aksu Görkem, Kocaelli Hümeyra, Hafiz Günter

机构信息

Department of Radiation Oncology, Medicine Faculty of Istanbul University, Istanbul, Turkey.

出版信息

Kulak Burun Bogaz Ihtis Derg. 2007;17(1):1-6.

PMID:17483603

Abstract

OBJECTIVES

We evaluated the results of surgical treatment and postoperative radiotherapy and prognostic factors in patients with primary tongue carcinoma.

PATIENTS AND METHODS

The study included 60 patients (31 males, 29 females; median age 54 years; range 22 to 82 years) who underwent surgery and postoperative radiotherapy for oral tongue cancer. Tumor staging based on the AJCC-1997 criteria was as follows: stage I (n=1), stage II (n=21), stage III (n=12), and stage IVA (n=26). Surgery included hemiglossectomy (n=46, 76%), partial (n=13, 22%) and total (n=1, 2%) glossectomy. Neck dissection was performed in 47 patients (78%). Radiotherapy dose was generally 6000 cGy/30 fr. The median follow-up was 51 months (range 5 to 180 months).

RESULTS

The five-year overall and relapse-free survival rates were 50% and 47%, respectively. Survival at five years was 70% for stage I-III, and 20% for stage IVA. Most of the relapses occurred in the first two years after treatment. Recurrences were encountered in 31 patients (52%). The median survival after recurrence was eight months (range 1 to 53 months). In multivariate analyses, significant prognostic factors for overall survival and locoregional control were tumor size, stage, N stage, extracapsular lymph node spread, and total duration of radiotherapy. Complications were within acceptable limits.

CONCLUSION

Postoperative radiotherapy should be standard for patients with stage III and IVA tongue cancer.

摘要

目的

我们评估了原发性舌癌患者的手术治疗、术后放疗结果及预后因素。

患者与方法

本研究纳入了60例因口腔舌癌接受手术及术后放疗的患者（男性31例，女性29例；中位年龄54岁；范围22至82岁）。根据美国癌症联合委员会（AJCC）1997年标准进行肿瘤分期如下：I期（n = 1），II期（n = 21），III期（n = 12），IVA期（n = 26）。手术包括半舌切除术（n = 46，76%）、部分舌切除术（n = 13，22%）和全舌切除术（n = 1，2%）。47例患者（78%）进行了颈部清扫术。放疗剂量一般为6000 cGy/30次分割。中位随访时间为51个月（范围5至180个月）。

结果

五年总生存率和无复发生存率分别为50%和47%。I - III期患者五年生存率为70%，IVA期为20%。大多数复发发生在治疗后的前两年。31例患者（52%）出现复发。复发后的中位生存时间为8个月（范围1至53个月）。在多因素分析中，总生存和局部区域控制的显著预后因素为肿瘤大小、分期、N分期、包膜外淋巴结扩散及放疗总时长。并发症在可接受范围内。