Leemans C R, Engelbrecht W J, Tiwari R, Devillé W L, Karim A B, van der Waal I, Snow G B
Department of Otolaryngology-Head and Neck Surgery, Free University Hospital, Amsterdam, The Netherlands.
Laryngoscope. 1994 Dec;104(12):1477-81. doi: 10.1288/00005537-199412000-00009.
The results after treatment of a total of 52 patients between 1974 and 1990 for squamous cell carcinoma of the soft palate and anterior tonsillar pillar by surgery, radiotherapy, or a combination of the two are reported in the present study. Of the 45 patients who were treated for cure, 38 were treated by surgery, followed by radiotherapy in 19 patients (50%). Five patients received definitive radiotherapy only, and 2 were treated by other modalities such as intra-arterial methotrexate and carbon dioxide (CO2) laser. Absolute and determinant 5-year survival rates were 62% and 77%, respectively. Sixty-four percent of patients survived 5 years recurrence-free, and 27% developed multiple primary tumors in the head and neck. Tumor stages III and IV were shown to decrease survival by half compared to stages I and II. A 42% occult nodal metastases rate was observed, and 3 of 11 patients experienced regional relapse in an untreated neck. From this review it appears that surgery, combined with postoperative radiotherapy when indicated, is an effective form of treatment for carcinoma of the soft palate and anterior tonsillar pillar.
本研究报告了1974年至1990年间共52例软腭和扁桃体前柱鳞状细胞癌患者接受手术、放疗或两者联合治疗后的结果。在45例接受根治性治疗的患者中,38例接受了手术治疗,其中19例(50%)术后接受了放疗。5例仅接受了根治性放疗,2例接受了其他治疗方式,如动脉内甲氨蝶呤和二氧化碳(CO2)激光治疗。绝对和决定性的5年生存率分别为62%和77%。64%的患者存活5年无复发,27%的患者在头颈部发生了多原发性肿瘤。与I期和II期相比,III期和IV期肿瘤患者的生存率降低了一半。观察到隐匿性淋巴结转移率为42%,11例患者中有3例在未治疗的颈部出现区域复发。从本综述来看,手术联合必要时的术后放疗是治疗软腭和扁桃体前柱癌的一种有效治疗方式。