Mazeron J J, Ghalie R, Zeller J, Marinello G, Marin L, Raynal M, Bourgeois J P, Pierquin B
Int J Radiat Oncol Biol Phys. 1986 Oct;12(10):1757-63. doi: 10.1016/0360-3016(86)90316-0.
From January 1970 to November 1982, 70 patients with carcinoma of the pinna were treated by interstitial irradiation. An afterloading technique with Iridium 192 wires was used. One patient recurred and had a total pinnectomy followed by 60 Gy external radiation. This patient was alive without evidence of disease at 134 months. Three patients who had tumors greater than 4 cm in size at presentation developed late necrosis which required subsequent total pinnectomy. Cosmetic results were assessed in 55 patients and were good with few late sequelae (in 78% of cases (36/46) when the tumor measured less than 4 cm, but only in 1/9 when the tumor measured more than 4 cm). We advocate interstitial Iridium 192 irradiation for treatment of pinna tumors smaller than 4 cm. None of 39 patients with squamous cell carcinoma had biopsy proven cervical lymph node metastasis at the time of diagnosis. Four patients with squamous cell carcinoma (4/39: 10%) later developed a regional nodal metastasis after treatment of the pinna. All four relapsed in the parotid region and were managed by partial parotidectomy and neck dissection followed by external irradiation. One of these four patients died from uncontrolled cervical node disease. In our opinion, when regular follow-up is dependable, it is reasonable to save treatment of the cervical nodes for those patients who relapse with involved metastatic cervical nodes.
1970年1月至1982年11月，70例耳廓癌患者接受了间质内照射治疗。采用铱192线后装技术。1例复发患者接受了全耳廓切除术，随后进行了60 Gy的外照射。该患者在134个月时存活，无疾病证据。3例初诊时肿瘤直径大于4 cm的患者发生晚期坏死，随后需要进行全耳廓切除术。对55例患者的美容效果进行了评估，效果良好，晚期后遗症较少（肿瘤直径小于4 cm的患者中78%（36/46）效果良好，而肿瘤直径大于4 cm的患者中只有1/9效果良好）。我们主张对直径小于4 cm的耳廓肿瘤采用铱192间质内照射治疗。39例鳞状细胞癌患者在诊断时均未活检证实有颈部淋巴结转移。4例鳞状细胞癌患者（4/39：10%）在耳廓治疗后出现区域淋巴结转移。这4例均在腮腺区复发，接受了部分腮腺切除术和颈部清扫术，随后进行了外照射。这4例患者中有1例死于无法控制的颈部淋巴结疾病。我们认为，当定期随访可靠时，对于出现转移性颈部淋巴结受累而复发的患者，保留颈部淋巴结治疗是合理的。
