Greiner R, Veraguth P
Schweiz Med Wochenschr. 1978 Jun 17;108(24):922-7.
About 80% of carcinomatous lesions of the lip are smaller than 2 cm in diameter, have little tendency to infiltrate, grow in the lower lip, are histologically well differentiated and do not have, or develop later, regional metastases. Of these carcinomas 95% are cured by the various methods of radiotherapy. The criteria for a more serious prognosis, such as expansive growth, deeper infiltration, location on the upper lip and/or the commissures, undifferentiated grading and regional lymphatic metastases, are found only in a minority of patients with carcinoma of the lip. However, even for tumors of the T3 category rates of cure of over 90% are reported, as confirmed by our own results with supervoltage irradiation with fast electrons of the betatron during the years 1961-1970. The techniques and indications of interstitial Curietherapy with iridium-192 wires are described. The treatment of primary lymphnode metastases, which should be confirmed histologically or cytologically before therapy, is described in detail. Neck dissection is superior to irradiation therapy. General elective neck dissection, as normally performed for carcinoma of the oral cavity, is not justified because of the low rate of metastases and the results of elective therapy. A case report demonstrates the poor prognosis in patients with regional fixed metastases.
唇部癌性病变约80%直径小于2厘米,浸润倾向小,生长在下唇,组织学上分化良好,且无区域转移或转移较晚出现。这些癌中95%可通过各种放疗方法治愈。预后较差的标准,如浸润性生长、浸润较深、位于上唇和/或口角、未分化分级以及区域淋巴结转移,仅见于少数唇部癌患者。然而,即使是T3期肿瘤,据报道治愈率也超过90%,这与我们1961年至1970年期间使用电子感应加速器的快电子进行超高压照射的结果相符。文中描述了用铱-192线进行组织间近距离放疗的技术和适应证。详细介绍了原发性淋巴结转移的治疗方法,治疗前应通过组织学或细胞学确诊。颈部清扫术优于放射治疗。由于转移率低和选择性治疗的结果,通常对口腔癌进行的一般性选择性颈部清扫术并不合理。一例病例报告显示区域固定转移患者预后较差。