Fietkau R, Grabenbauer G G, Iro H, Müller R G, Farmand M, Atendorf-Hofmann A, Sauer R
Strahlentherapeutische Klinik, Universität Erlangen-Nürnberg.
Strahlenther Onkol. 1991 Oct;167(10):591-8.
From 1.1. 1986 to 31.12. 1990 50 patients with epidermoid carcinoma of the floor of the mouth and the mobile tongue (stage T1 18, stage T2 20, stage T3 eight and stage T4 four patients) were treated by surgery, 192-iridium implantation using the plastic tube technique and percutaneous irradiation. Surgery was performed as enoral resection (35 patients) or en bloc tumour resection with part of the mandible and flap reconstruction (15 patients). Interstitial therapy was considered as a boost to primary tumour region, the dose given ranged between 16 and 33 Gy. 50 to 60 Gy were applied with external beam radiotherapy. Management of the neck consisted of elective or radical neck dissection followed by external beam radiotherapy (50 to 60 Gy). At 2/1991 median follow-up was 17 (three to 53) months. 35 patients are alive and tumour-free, one patient lives with tumour. 14 patients died, eight patients tumour-related, four patients of intercurrent disease and two patients because of a second primary. Primary local control was 18/18 patients for stage T1, 19/20 patients for stage T2, 7/8 patients T3, 3/4 patients for stage T4. Three patients suffered from nodal recurrences, four patients from distant metastases. Complication rate was acceptable. Soft tissue necrosis occurred in 4/18 patients (T1); 5/20 patients (T2); 3/8 patients (T3) and 1/4 patients (T4). Three patients developed osteoradionecrosis. Our results show that combined modality treatment for tumours of the oral cavity yields high local control with acceptable complication rate.
1986年1月1日至1990年12月31日期间，50例口底和活动舌部表皮样癌患者（T1期18例，T2期20例，T3期8例，T4期4例）接受了手术、采用塑料管技术的192铱植入及经皮照射治疗。手术方式为经口切除（35例）或肿瘤整块切除并部分下颌骨切除及皮瓣重建（15例）。组织间治疗被视为对原发肿瘤区域的强化治疗，给予的剂量在16至33 Gy之间。外照射放疗给予50至60 Gy。颈部处理包括选择性或根治性颈清扫，随后进行外照射放疗（50至60 Gy）。1991年2月时，中位随访时间为17（3至53）个月。35例患者存活且无肿瘤，1例患者带瘤生存。14例患者死亡，8例死于肿瘤相关原因，4例死于并发疾病，2例死于第二原发肿瘤。T1期患者原发灶局部控制率为18/18，T2期为19/20，T3期为7/8，T4期为3/4。3例患者出现颈部复发，4例出现远处转移。并发症发生率可接受。软组织坏死发生在T1期的4/18例患者中；T2期的5/20例患者中；T3期的3/8例患者中；T4期的1/4例患者中。3例患者发生放射性骨坏死。我们的结果表明，口腔肿瘤的综合治疗可获得较高的局部控制率，且并发症发生率可接受。
