Horiuchi J, Okuyama T, Shibuya H, Takeda M
Int J Radiat Oncol Biol Phys. 1982 May;8(5):829-35. doi: 10.1016/0360-3016(82)90085-2.
One hundred and sixty-six patients with squamous cell carcinoma of the tongue were treated with radiation. Treatment modalities were mainly interstitial implant with or without external beam irradiation, except for early lesions, which were treated with intraoral electron beam therapy. Analysis was made on the local prognosis of the lesion to clarify the indications for interstitial therapy, especially the combined program with external beam therapy, and the time-dose relationship of the brachytherapy. Local recurrence-free rates (two years) were 94% in T1, 77% in T2 and 32% in T3 lesions, respectively. For T1 and superficial or exophytic T2 lesions, the local recurrence-free rate was excellent with the interstitial therapy alone using either permanent implants of gold grain or radium implants. Therefore, prior external beam therapy seemed to be unnecessary for these lesions. When the treated area was less than 10 cm2, subsequent complications were not likely even if the TDF (time-dose factor) value was high. Most of the patients who received combined external beam and interstitial therapy showed infiltrative T2 and a majority of the T3 lesions. In these patients, it was apparent that most of the total dose should be given from the interstitial implant after a small prior dose with external irradiation, because these lesions could not be cured even if the external dose was increased.
166例舌鳞状细胞癌患者接受了放射治疗。治疗方式主要为间质植入，可联合或不联合外照射，早期病变采用口腔内电子束治疗。对病变的局部预后进行分析，以明确间质治疗的适应证，尤其是与外照射联合的方案，以及近距离治疗的时间-剂量关系。T1、T2和T3病变的局部无复发生存率（两年）分别为94%、77%和32%。对于T1以及浅表或外生性T2病变，单独使用金粒永久植入或镭植入的间质治疗局部无复发生存率极佳。因此，这些病变似乎无需先行外照射治疗。当治疗面积小于10 cm²时，即使TDF（时间-剂量因子）值较高，后续并发症也不太可能发生。大多数接受外照射与间质治疗联合的患者表现为浸润性T2以及大部分T3病变。在这些患者中，显然大部分总剂量应在先行少量外照射后由间质植入给予，因为即使增加外照射剂量，这些病变也无法治愈。
