Yamazaki Hideya, Inoue Takehiro, Yoshida Ken, Kotsuma Tadayuki, Yoshioka Yasuo, Koizumi Masahiko, Furukawa Souhei, Kakimoto Naoya, Shimizutani Kimishige, Nishimura Tsunehiko
Department of Radiology, Kyoto Prefectural University of Medicine, 465 Kajiicho Kawaramachi Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan.
Tumori. 2009 Jul-Aug;95(4):461-6. doi: 10.1177/030089160909500409.
To examine the background characteristics of elderly patients (65 years or older) with node-negative mobile tongue cancer (T1-2N0M0) who showed worse local control than a younger group.
We retrospectively analyzed background data for 265 patients treated with brachytherapy with or without external radiotherapy between 1967 and 1999. We examined dental factors (such as irritation by prosthesis), leukoplakia, tobacco smoking and alcohol consumption for comparisons between the elderly (age > or = 65 years; n = 83) and a control group (64 years or younger; n = 182).
The elderly patients showed a worse outcome than the control group (respectively 86% and 70% at 5 years; P < 0.05). Incidence of dental factors tended to be higher for elderly patients (53%) than the control group (40%, P = 0.07). Dental factors proved to have prognostic importance for local control. Five-year local control rate was 85% for patients with and 76% for patients without dental factors (P = 0.04). The elderly group positive for dental factors showed a lower 5-year local control rate (61%) than the other three groups [(elderly without the dental factor (-) group (80%), control with the dental factor (+) group (84%), and control without the dental factor (-) group (87%)] (P < 0.05). Leukoplakia was found more frequently in the control (23%) than in the elderly group (5%) (P = 0.006) but had no effect on treatment outcome.
Age and dental factors (including prosthesis irritation) are potentially important prognostic factors for local control of oral tongue cancer treated with brachytherapy, especially for elderly patients.
研究年龄≥65岁的无淋巴结转移的可移动舌癌（T1-2N0M0）老年患者局部控制情况比年轻组差的相关背景特征。
回顾性分析1967年至1999年间接受近距离放疗联合或不联合外照射放疗的265例患者的背景数据。我们研究了牙齿因素（如假牙刺激）、白斑、吸烟和饮酒情况，以比较老年组（年龄≥65岁；n = 83）和对照组（年龄≤64岁；n = 182）。
老年患者的预后比对照组差（5年时分别为86%和70%；P < 0.05）。老年患者牙齿因素的发生率（53%）往往高于对照组（40%，P = 0.07）。牙齿因素被证明对局部控制具有预后重要性。有牙齿因素的患者5年局部控制率为85%，无牙齿因素的患者为76%（P = 0.04）。牙齿因素阳性的老年组5年局部控制率（61%）低于其他三组[（无牙齿因素的老年组（80%）、有牙齿因素的对照组（84%）和无牙齿因素的对照组（87%）]（P < 0.05）。对照组白斑的发生率（23%）高于老年组（5%）（P = 0.006），但对治疗结果无影响。
年龄和牙齿因素（包括假牙刺激）可能是口腔舌癌近距离放疗局部控制的重要预后因素，尤其是对老年患者。
