Jose B, Banis J, Flynn M, Lindberg R, Spanos W J, Paris K, Rohm J
Department of Radiation Oncology, Brown Cancer Center, University of Louisville School of Medicine, KY 40202.
Head Neck. 1991 May-Jun;13(3):213-6. doi: 10.1002/hed.2880130308.
The aim of this study was to analyze the effects of surgery, irradiation, and free tissue transfer in locally advanced head and neck cancer patients. Forty-one patients with head and neck cancer were treated with surgery, irradiation, and free tissue transfer for reconstruction from 1977 to 1987. The age range was 38 to 78 years with a median age of 61. Patients were staged using the AJCC (1978) staging system. Eighty-four percent of the patients were in stage III or IV. The common sites of primary tumors were the oral cavity (22) and oropharynx (10). Forty patients had squamous cell carcinoma and 1 patient had basal cell carcinoma. Six patients had preoperative irradiation, and the rest had postoperative irradiation. The most common surgical procedures were partial glossectomy and neck dissection (17 patients) and wide excision of the primary and neck dissection (17 patients). The most common types of free tissue transfer were dorsalis pedis (13 patients) and scapular flaps (6 patients). The primary site was controlled in 22 patients (54%) and the neck in 36 patients (88%). Three patients (7.3%) had flap failure which required further surgical management. Eighteen patients are living with no evidence of disease with a median follow-up of 18 months (5-101 months), 10 patients are living with disease with a median follow-up of 9 months (3-40 months), 9 patients are dead of disease with a median survival of 13 months (6-54 months), and 4 patients are lost for follow-up. This study shows that free tissue transfer before or after irradiation is of benefit with few complications.
本研究的目的是分析手术、放疗和游离组织移植对局部晚期头颈癌患者的影响。1977年至1987年期间，41名头颈癌患者接受了手术、放疗和游离组织移植重建治疗。年龄范围为38至78岁，中位年龄为61岁。患者采用美国癌症联合委员会（1978年）分期系统进行分期。84%的患者处于III期或IV期。原发肿瘤的常见部位为口腔（22例）和口咽（10例）。40例患者为鳞状细胞癌，1例患者为基底细胞癌。6例患者术前行放疗，其余患者术后行放疗。最常见的手术方式是部分舌切除术和颈部清扫术（17例患者）以及原发灶广泛切除术和颈部清扫术（17例患者）。最常见的游离组织移植类型是足背皮瓣（13例患者）和肩胛皮瓣（6例患者）。22例患者（54%）的原发部位得到控制，36例患者（88%）的颈部得到控制。3例患者（7.3%）出现皮瓣失败，需要进一步手术处理。18例患者存活且无疾病证据，中位随访时间为18个月（5 - 101个月），10例患者存活但有疾病，中位随访时间为9个月（3 - 40个月），9例患者死于疾病，中位生存期为13个月（6 - 54个月），4例患者失访。本研究表明，放疗前后进行游离组织移植有益且并发症较少。
