Korb L J, Spaulding C A, Constable W C
Division of Radiation Oncology, University of Virginia Health Sciences Center, Charlottesville 22908.
Cancer. 1991 Jun 1;67(11):2733-7. doi: 10.1002/1097-0142(19910601)67:11<2733::aid-cncr2820671103>3.0.co;2-t.
Between 1968 and 1985, 114 patients with squamous cell carcinoma of the tongue were evaluated in the Department of Radiation Oncology at the University of Virginia (Charlottesville, VA); of these, 86 received treatment with curative intent. The majority were treated with radiation therapy alone, whereas the remainder were treated with radiation therapy with preoperative or postoperative surgery. There were 17 T1 primary malignancies, 40 T2, 27 T3, and 2 T4. Clinically positive adenopathy was present in 48% of the patients overall and ranged from 35% in the T1 group to 100% in the T4 group. Twenty-six percent of patients either presented with or later had second malignancies. At 36 months, the patient status was evaluated as dead of disease (37%), dead of intercurrent disease (23%), alive with disease (1%), and alive without evidence of disease (38%). Seventy-five patients received external beam therapy and 32 patients received an implant as either all or part of their treatment. Average doses were in the range of 6000 Gy. Adjusted local control rate at 3 years was not statistically different for different treatment techniques used on either T1 or T2 primary malignancies. The rates were 89% versus 88% for T1 lesions treated with definitive radiation therapy versus postoperative radiation therapy. For T2 primary malignancies, the rates were 67%, 71%, and 83% for the definitive, preoperative, and postoperative radiation therapy groups, respectively. For T3 lesions, there was close to statistical significance with the corresponding rates being 47%, 50%, and 100%, respectively. When the effect of implants was examined for T1 and T2 lesions, no difference in local control rate at 3 years was noticed with or without an implant. Survival was improved for the group presenting with positive neck disease when compared with the N0 group. The external beam severe complication rate was less than 5%, and the implant complication rate was 6%.
1968年至1985年间，弗吉尼亚大学（弗吉尼亚州夏洛茨维尔）放射肿瘤学系对114例舌鳞状细胞癌患者进行了评估；其中86例接受了根治性治疗。大多数患者仅接受放射治疗，其余患者则接受放射治疗联合术前或术后手术。有17例T1期原发性恶性肿瘤、40例T2期、27例T3期和2例T4期。总体上48%的患者临床上存在阳性淋巴结病，T1组为35%，T4组为100%。26%的患者出现或后来发生了第二原发性恶性肿瘤。36个月时，患者状态评估为死于疾病（37%）、死于并发疾病（23%）、带瘤生存（1%）和无疾病证据生存（38%）。75例患者接受了外照射治疗，32例患者接受了植入治疗，植入治疗作为全部或部分治疗手段。平均剂量在6000戈瑞范围内。对于T1或T2期原发性恶性肿瘤采用的不同治疗技术，3年时的调整局部控制率无统计学差异。T1期病变采用根治性放射治疗与术后放射治疗的局部控制率分别为89%和88%。对于T2期原发性恶性肿瘤，根治性、术前和术后放射治疗组的局部控制率分别为67%、71%和83%。对于T3期病变，相应的局部控制率分别为47%、50%和100%，接近统计学意义。当检查T1和T2期病变植入治疗的效果时，发现有或无植入治疗在3年时的局部控制率无差异。与N0组相比，颈部疾病阳性组的生存率有所提高。外照射严重并发症发生率低于5%，植入治疗并发症发生率为6%。
