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唇癌治疗方法的选择——74例病例分析

[Choice of the treatment for lip carcinoma--an analysis on 74 cases].

作者信息

Wu X L

出版信息

Zhonghua Zhong Liu Za Zhi. 1985 Sep;7(5):357-60.

PMID:4092579
Abstract

This paper reports the results of the treatment of 74 patients with lip carcinoma from 1958-1974. All patients were proved by pathology and received their first course of treatment in our hospital. 44 of these patients were treated by radiation and 30, by surgery. The over-all five-year survival rate is 59% (44/74). Satisfactory results were obtained in the early lesions (stages I, II) either by surgery or radiation and the five-year survival rates are 66% (surgery 6/9, radiation 4/6). For stages III and IV, the result of operation is better than radiation's. The five-year survival rate in the former is 71% (15/21) and in the latter is 50% (19/38). In the stage IV lesions (T4), surgery was contraindicated but radiation was still able to cure 25% (1/4) of the patients. The optimal dose for the primary lesion was 6000-8000 rad/6-8 wk. For patients without any metastasis in the neck lymph nodes or with suspicious ones (N0, N1a, N2a), 12% (4/33) developed cervical metastasis if the upper neck area was left untreated. Yet none of them developed metastasis if the neck was treated prophylactically either by radiation (3000-4000 rad/3-4 wk) or by surgery. For patients with positive neck lymph nodes (N1b, N2b, N3), surgery was better than radiation (4000-6000 rad/4-6 wk).

摘要

本文报告了1958年至1974年间74例唇癌患者的治疗结果。所有患者均经病理证实,并在我院接受了首次治疗。其中44例患者接受了放射治疗,30例接受了手术治疗。总体五年生存率为59%(44/74)。早期病变(I期、II期)通过手术或放射治疗均取得了满意的结果,五年生存率分别为66%(手术6/9,放射治疗4/6)。对于III期和IV期患者,手术效果优于放射治疗。前者的五年生存率为71%(15/21),后者为50%(19/38)。在IV期病变(T4)中,手术为禁忌,但放射治疗仍能治愈25%(1/4)的患者。原发灶的最佳剂量为6000 - 8000拉德/6 - 8周。对于颈部淋巴结无转移或可疑转移的患者(N0、N1a、N2a),如果未对上颈部区域进行治疗,12%(4/33)会发生颈部转移。然而,如果通过放射治疗(3000 - 4000拉德/3 - 4周)或手术进行预防性颈部治疗,则无一例发生转移。对于颈部淋巴结阳性的患者(N1b、N2b、N3),手术治疗优于放射治疗(4000 - 6000拉德/4 - 6周)。

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