Vikram B
Arch Otolaryngol. 1984 Sep;110(9):564-5. doi: 10.1001/archotol.1984.00800350006003.
We treated 98 previously untreated patients with stages III and IV resectable epidermoid carcinoma of the oral cavity, oropharynx, and larynx with surgery and postoperative radiation therapy. The reasons for postoperative radiation therapy were unsatisfactory surgical margins in 36 patients, cervical metastases at multiple levels pathologically in 49, and both in 13. Historically, patients with similar findings, treated by surgery alone at our institution, had a relapse rate above the clavicles of more than 70% within two years. In the present series only 15% have had relapses above the clavicles, and distant metastases developed in another 20%. In addition, approximately 6% of patients per year have had second malignant neoplasms develop, predominantly in the esophagus or the lung. These changes in the patterns of failure have implications for future studies aimed at improving the cure rate and the survival of these patients.
我们对98例先前未经治疗的Ⅲ期和Ⅳ期可切除口腔、口咽和喉表皮样癌患者进行了手术及术后放射治疗。术后放射治疗的原因包括：36例手术切缘不满意，49例有多个层面的颈部病理转移，13例两者皆有。从历史数据来看，我院有类似表现的患者若仅接受手术治疗，两年内锁骨以上复发率超过70%。在本系列中，只有15%的患者出现了锁骨以上复发，另有20%发生了远处转移。此外，每年约6%的患者发生了第二原发性恶性肿瘤，主要发生在食管或肺部。这些失败模式的变化对旨在提高这些患者治愈率和生存率的未来研究具有重要意义。
