Wilder R B, Kittelson J M, Shimm D S
Department of Radiation Oncology, University Medical Center, Tucson, AZ 85724.
Cancer. 1991 Nov 15;68(10):2134-7. doi: 10.1002/1097-0142(19911115)68:10<2134::aid-cncr2820681008>3.0.co;2-m.
Between 1974 and 1989, 85 patients with 115 biopsy-proven basal cell carcinomas were treated with radiation therapy at the University Medical Center in Tucson. Either orthovoltage or megavoltage photons were used to deliver doses ranging from 2000 cGy in a single treatment to 7300 cGy in 35 fractions over 62 days. The median length of follow-up was 40 months. Kaplan-Meier estimates of the 5-year local control rates are presented by American Joint Committee on Cancer stage. The difference between the local control rates for both previously untreated and recurrent Stage I and II carcinomas (95% at 5 years) and Stage III and IV carcinomas (56% at 5 years) was statistically significant (P = 0.0001, by Mantel-Haensel test). Although recurrent basal cell carcinomas generally have a worse prognosis, the Kaplan-Meier estimate of the 5-year local control rate for recurrent Stage I and II carcinomas treated with radiation therapy was 95%. These results, along with a review of the literature, suggest two points: (1) high cure rates can be obtained when Stage I and II basal cell carcinomas are treated with radiation therapy and (2) radiation therapy is a relatively effective method for treating recurrent basal cell carcinomas, with cure rates surpassed only by Mohs micrographic surgery.
1974年至1989年间，图森市大学医学中心对85例经活检证实的115例基底细胞癌患者进行了放射治疗。采用深部X线或兆伏光子放疗，单次治疗剂量范围为2000 cGy，62天内分35次给予7300 cGy。中位随访时间为40个月。根据美国癌症联合委员会分期给出了5年局部控制率的Kaplan-Meier估计值。先前未治疗的以及复发性I期和II期癌（5年局部控制率为95%）与III期和IV期癌（5年局部控制率为56%）的局部控制率差异具有统计学意义（Mantel-Haensel检验，P = 0.0001）。尽管复发性基底细胞癌的预后通常较差，但接受放射治疗的复发性I期和II期癌的5年局部控制率的Kaplan-Meier估计值为95%。这些结果以及文献综述表明两点：（1）I期和II期基底细胞癌采用放射治疗可获得较高的治愈率；（2）放射治疗是治疗复发性基底细胞癌的一种相对有效的方法，治愈率仅次于莫氏显微外科手术。
