Marcial V A, Pajak T F
Cancer. 1985 May 1;55(9 Suppl):2259-65. doi: 10.1002/1097-0142(19850501)55:9+<2259::aid-cncr2820551432>3.0.co;2-7.
Radiation therapy alone, surgery alone, or the combination of these two modalities, remain the accepted treatments in the management of epidermoid carcinomas of the mucosa of the head and neck. These modalities of therapy produce comparable results; but, radiotherapy alone has the advantage that it can conserve anatomy and function. Irradiation with teletherapy techniques, at times supplemented by interstitial brachytherapy, with doses ranging from 6600 to 8000 cGy, results in satisfactory tumor response (CR). The CR of T1N0 and T2N0 lesions will be 99% and 90% respectively, but only 29% in T4N3 tumors treated with radiation only. To improve on the limited CR rate achieved in the advanced stages, surgery is combined pre or post-irradiation, or reserved for the salvage of failures. In the oral cavity and oropharynx, these possible options give comparable tumor control and survival, but in the supraglottic larynx post-operative irradiation is superior to pre-operative radiotherapy. Tumor recurrence rates in the head and neck range from 15 to 34% depending on initial site, stage and type of therapy. Cancer control activities that emphasize prevention and early diagnosis should present a better future for these patients.
单独放疗、单独手术或这两种方式的联合，仍是头颈部黏膜表皮样癌治疗中被认可的治疗方法。这些治疗方式产生的结果相当；但是，单独放疗具有能保留解剖结构和功能的优势。采用远距离治疗技术进行照射，有时辅以组织间近距离放疗，剂量范围为6600至8000厘戈瑞，可使肿瘤获得满意的反应（完全缓解）。T1N0和T2N0病变的完全缓解率分别为99%和90%，但仅接受放疗的T4N3肿瘤的完全缓解率仅为29%。为了提高晚期患者有限的完全缓解率，可在放疗前或放疗后联合手术，或留待挽救治疗失败时使用。在口腔和口咽部位，这些可能的选择能带来相当的肿瘤控制效果和生存率，但在声门上型喉癌中，术后放疗优于术前放疗。头颈部肿瘤的复发率在15%至34%之间，具体取决于初始部位、分期和治疗类型。强调预防和早期诊断的癌症控制活动应为这些患者带来更好的未来。
