Rasse Michael
Klinische Abteilung für Mund-, Kiefer- und Gesichtschirurgie, Medizinische Universität Innsbruck, Innsbruck, Austria.
Wien Med Wochenschr. 2008;158(9-10):243-8. doi: 10.1007/s10354-008-0528-9.
The squamous cell carcinoma of the oral cavity comprises 3% of all new cancer cases. 10% have a hereditary component. Smokers stand at a 3-fold higher risk with alcohol as an additive factor. 6 to 10 independent genetic events are expected to take place until invasive carcinoma occurs. Chromosomal deletion may also be detected in premalignant lesions. Staging is performed with inspection including endoscopy, CT- and MR-Scans and biopsy for the primary tumour and chest-X-ray, CT, Ultrasound and Scintigraphy for the N and M stage routinely. Therapeutic options that are proven best are radiation or/and surgery for T1 and T2 stages with a 5-year survival rate between 80% and 100%. Multimodal therapies, also including chemotherapy for higher stages result in 5-year survival rates between 55% and 62%. Since recurrence and metastasis have very poor prognosis sufficient and radical primary therapy is crucial. Palliative chemotherapy may be applied for functional improvement and pain release without statistical prove for increased survival rates.
口腔鳞状细胞癌占所有新发癌症病例的3%。其中10%有遗传因素。吸烟者患口腔鳞状细胞癌的风险高出3倍,酒精是一个附加因素。在浸润性癌发生之前,预计会发生6至10个独立的基因事件。在癌前病变中也可能检测到染色体缺失。分期通常通过检查进行,包括内镜检查、CT和磁共振扫描以及对原发性肿瘤进行活检,对N和M期进行胸部X线、CT、超声和闪烁扫描。经证实的最佳治疗方案是T1和T2期采用放疗或/和手术,5年生存率在80%至100%之间。多模式治疗,包括更高分期的化疗,5年生存率在55%至62%之间。由于复发和转移的预后非常差,充分而彻底的初始治疗至关重要。姑息性化疗可用于改善功能和缓解疼痛,但尚无提高生存率的统计学证据。