Fletcher G H, Jessee R H
Cancer. 1977 Feb;39(2 Suppl):862-7. doi: 10.1002/1097-0142(197702)39:2+<862::aid-cncr2820390723>3.0.co;2-7.
Lesions of the skin are best excised except for specific locations where surgical excision would not likely produce disease-free margins and/or would require extensive plastic repair. A control rate of 90% for T1 lesions and 80% for T2 lesions is obtained with irradiation in the squamous cell carcinomas of the upper respiratory and digestive tract. Heavy smokers and/or severe alcoholics may be preferably treated surgically. The control rates in the T3 and T4 lesions are unsatisfactory with either irradiation or surgery alone. Pre- or postoperative irradiation combined with the appropriate surgical procedure improves the local control rates and to some extent the survival rates. Postoperative irradiation for the highly malignant tumors of the salivary gland reduces the local failure rate from 36% to 11%. The facial nerve can be preserved unless it is grossly involved.
除了某些特定部位，皮肤病变最好进行切除，因为在这些部位手术切除不太可能获得无瘤切缘，和/或需要广泛的整形修复。在上呼吸道和消化道鳞状细胞癌中，T1病变的放疗控制率为90%，T2病变为80%。重度吸烟者和/或重度酗酒者可能首选手术治疗。单独放疗或手术治疗T3和T4病变的控制率都不尽人意。术前或术后放疗联合适当的手术操作可提高局部控制率，并在一定程度上提高生存率。唾液腺高度恶性肿瘤术后放疗可将局部失败率从36%降至11%。除非面神经明显受累，否则可以保留。
