Bujko K
Zakładu Radioterapii II. Centrum Onkologii-Instytutu im. M. Skłodowskiej-Curie, Warszawie.
Otolaryngol Pol. 1993;47(1):3-12.
Medical records of 222 patients with neck nodes metastases from squamous cell carcinoma of supraglottic larynx (122 cases), tonsil (63 cases) and base of tongue (37 cases) were analyzed. All cases were treated with definitive irradiation between 1970-1981. One hundred ten patients were treated with orthovoltage technique with total doses of 5000-6000 rads, 150-180 rads per fraction; 112 patients with Co60 with total doses 6000-7000 rads, 180-230 rads per fraction. Local-regional control was achieved in 28% of cases. Failures in the neck nodes with primary tumour controlled, were recorded in 10% of patients. Failures in a primary tumour alone were observed in 26% of patients, in primary tumour and neck nodes in 36%. Radiocurability of primary tumour and involved neck nodes was similar. In cases with primary tumour controlled, the probability of eradication of neck nodes metastases is high, even in N3 stage patients. Residual neck nodes palpable 1 to 3 months after irradiation were unfavourable prognostic factor indicated 50% risk of neck recurrence. In patients with complete regression of primary and nodal disease, failure in neck nodes was recorded in 5% of cases. The role of surgery following irradiation in patients with cervical nodes metastases is discussed.
对222例声门上型喉鳞状细胞癌（122例）、扁桃体癌（63例）和舌根癌（37例）颈部淋巴结转移患者的病历进行了分析。所有病例均在1970年至1981年间接受了根治性放疗。110例患者采用深部X线技术治疗，总剂量为5000 - 6000拉德，每次分割剂量为150 - 180拉德；112例患者采用钴60治疗，总剂量为6000 - 7000拉德，每次分割剂量为180 - 230拉德。28%的病例实现了局部区域控制。原发肿瘤得到控制但颈部淋巴结出现复发的患者占10%。仅原发肿瘤出现复发的患者占26%，原发肿瘤和颈部淋巴结均出现复发的患者占36%。原发肿瘤和受累颈部淋巴结的放射可治愈性相似。在原发肿瘤得到控制的病例中，即使是N3期患者，颈部淋巴结转移灶被根除的概率也很高。放疗后1至3个月可触及残留颈部淋巴结是不良预后因素，提示颈部复发风险为50%。对颈部淋巴结转移患者放疗后手术的作用进行了讨论。
