Feldman M, Fletcher G H
Int J Radiat Oncol Biol Phys. 1982 Jan;8(1):27-30. doi: 10.1016/0360-3016(82)90380-7.
One hundred and two patients with squamous cell carcinoma of the oral cavity or oropharynx were treated from January 1955 through August 1976 with surgical excision followed by irradiation. Twelve patients had T2 lesions and 90 had T3 or T4 lesions. Failures above the clavicles were associated with disease present at the margins of resection, location of the recurrence close to the periphery, or outside of the irradiated portals. Failure in the neck essentially were a result of no elective irradiation. In patients with disease present at the margins of resection, there is a risk both of gross residual disease and hypoxic microscopic disease left behind; 4500 to 5000 rad is not adequate for a significant control rate. In situation where there is definite disease at the margin of resection, 6500 rad, or in specific situations, 7000 rad, should be given through reduced fields.
1955年1月至1976年8月期间，对102例口腔或口咽鳞状细胞癌患者进行了手术切除并辅以放疗的治疗。12例患者为T2期病变，90例为T3或T4期病变。锁骨以上区域的治疗失败与切除边缘存在病变、复发部位靠近周边或在照射野之外有关。颈部治疗失败主要是由于未进行选择性放疗。在切除边缘存在病变的患者中，存在肉眼残留病变和遗留缺氧微小病变的风险；4500至5000拉德的剂量不足以实现显著的控制率。在切除边缘存在明确病变的情况下，应通过缩小照射野给予6500拉德，或在特定情况下给予7000拉德。
