Department of Dentistry, Oral and Maxillofacial Surgery, Jichi Medical University, 3311-1 Yakushiji , Shimotsuke-shi, Tochigi, 329-0498, Japan.
Department of Dentistry, Oral and Maxillofacial Surgery, National Hospital Tochigi Hospital, 1-10-37 Nakatomatsuri, Utsunomia, Tochigi, 320-8580, Japan.
J Med Case Rep. 2022 Apr 29;16(1):178. doi: 10.1186/s13256-022-03311-z.
It is very important to determine the indication of mold radiotherapy for the radical treatment of oral cancer. We investigated eight patients with oral squamous cell carcinoma who were treated by radical irradiation with mold radiotherapy using a customized device.
The subject is a case of curable superficial oral cancer of a few millimeters, or cancer of a size that can be cured by the placement of the radiation source. Of the eight patients, six were male and two were female, aged 64-93 years (mean, 78.9 years; median, 73.5 years). The primary sites were the buccal mucosa in three cases, gingiva in two cases, and floor of the mouth, soft palate, and lower lip in one case each. Five cases were in the T1 stage, and the remaining three cases were in T2. With respect to thickness, seven cases were of the superficial type and could not be detected by magnetic resonance imaging or computed tomography, and the remaining case showed a tumor thickness of 7.5 mm. All cases were diagnosed as squamous cell carcinoma by biopsy. Radical irradiation using mold radiotherapy was planned for all eight patients. Irradiation was delivered in 9-10 sessions, with a total dose of 45-50 Gy.
Complete response was attained in six of the eight patients and partial response was observed in two patients, requiring additional treatment.
Since all patients with complete response had superficial cancers, we hypothesized that superficial cancers of the oral cavity with thicknesses of few millimeters could be indicated for mold irradiation. This method can be applied in complicated cases and older patients in whom surgery or chemotherapy may not be feasible. We believe that the results of our clinical studies will be of great help in choosing this method.
对于口腔癌的根治性治疗,确定模具放疗的适应证非常重要。我们调查了 8 例使用定制设备进行模具放疗的口腔鳞状细胞癌患者。
本研究对象为几毫米可治愈的表浅口腔癌,或可通过放置放射源治愈的癌症。8 例患者中,男 6 例,女 2 例;年龄 64-93 岁,平均 78.9 岁,中位数 73.5 岁;原发部位为颊黏膜 3 例,牙龈 2 例,口底、软腭和下唇各 1 例;T1 期 5 例,T2 期 3 例;根据厚度,7 例为表浅型,磁共振成像或计算机断层扫描无法检测到,其余 1 例肿瘤厚度为 7.5mm。所有病例均经活检诊断为鳞状细胞癌。对 8 例患者均行模具放疗根治性照射。照射共 9-10 次,总剂量 45-50Gy。
8 例患者中,6 例完全缓解,2 例部分缓解,需追加治疗。
由于完全缓解的患者均为表浅癌,我们推测几毫米表浅口腔癌可能适用于模具照射。该方法可应用于手术或化疗不可行的复杂病例和老年患者。我们相信,我们的临床研究结果将对选择这种方法有很大帮助。