Gilbert E H, Goffinet D R, Bagshaw M A
Cancer. 1975 Jun;35(6):1517-24. doi: 10.1002/1097-0142(197506)35:6<1517::aid-cncr2820350607>3.0.co;2-3.
One hundred fourteen patients with carcinoma of the oral tongue and floor of mouth were treated with high-dose megavoltage radiation at Stanford University from 1956 to1970. Actuarial 5-year survival for 56 patients with oral tongue lesions was: T', 73; T', 37%; and T', 19%. Similarly, for 58 patients with lesions of the floor mouth, 5-year survival was: T', 73%; T', 37%; and T', 25%. Local control of the primary was obtained in oral tongue T' lesions 10 of 11 times; T', 5 of 8; and T', 13 of 36 times. For floor of mouth, local control was: T', 22 of 26;T', 7 of 14; andT', 3 of 15. There was an indication that better control was obtained if interstitialtherapy was a planned part of the treatment. Dose for local control when external radiation alone was utilized was usually over 1900 rets. Patients with initially clinicallynegative nodes (TXNO) who had a low radiation dose to primary echelon lymph nodes developed later cervical lymph node metastases 38% of the time. In no case did late metastatic disease appear in patients whose necks were treated prophylactically.
1956年至1970年期间,斯坦福大学对114例舌癌和口底癌患者进行了大剂量兆伏级放疗。56例舌部病变患者的5年精算生存率为:T1期,73%;T2期,37%;T3期,19%。同样,58例口底病变患者的5年生存率为:T1期,73%;T2期,37%;T3期,25%。舌部T1期病变11次中有10次实现了原发灶的局部控制;T2期,8次中有5次;T3期,36次中有13次。口底的局部控制情况为:T1期,26次中有22次;T2期,14次中有7次;T3期,15次中有3次。有迹象表明,如果将间质治疗作为治疗计划的一部分,可获得更好的控制效果。仅采用外照射时,局部控制所需剂量通常超过1900拉德。最初临床检查淋巴结阴性(TXNO)且对一级淋巴引流区原发灶放疗剂量较低的患者,38%出现了颈部淋巴结转移。预防性治疗颈部的患者无一例出现晚期转移疾病。