Inoue T, Inoue T, Teshima T, Murayama S, Nose T, Tanaka E, Yamazaki H, Koizumi M, Kagawa K, Ozeki S, Ikeda H
Department of Radiation Oncology, Osaka University Medical School, Japan.
Strahlenther Onkol. 1996 Jun;172(6):301-5.
BACKGROUND/AIM: Late local recurrence after radiotherapy for tongue and early glottic carcinoma is rarely discussed. In the head and neck cancer, approximately 90% of local recurrence occurred within 2 years after radiotherapy. However, we found that late local recurrence after radiotherapy for glottic cancer was not rare. Our aim was to evaluate the late local recurrence after radiotherapy for early glottic and tongue cancer.
From 1967 through 1982, 633 patients with tongue carcinoma and 330 patients with early (T1T2N0) glottic carcinomas were treated at the Department of Radiology, Osaka University Hospital. Of these 821 patients, 329 patients with tongue carcinoma and 221 patients with early glottic carcinoma survived at 5 years after radiotherapy without local recurrence. For tongue carcinoma, patients were divided by T category. For early glottic carcinoma, patients were divided by the tumor response at 40 Gy.
Late local recurrence occurred in 23 of 329 patients (7%) with tongue carcinoma, and in 9 of 221 (4%) with early glottic carcinoma. For tongue carcinoma, late recurrence occurred in 19 of 249 patients (8%) in stage I and II, and 4 of 80 patients (5%) in stage III and IV. For glottic carcinoma, late recurrence occurred in 8 of 137 patients (6%) with tumor clearance at 40 Gy and 1 of 63 patients (2%) with tumor persistence at 40 Gy. The incidence of double cancer was also evaluated. Of 329 5-year survivors with tongue carcinoma, 39 patients (12%) had another malignancy, and 26 patients of 221 5-year survivors with early glottic carcinoma (12%) had also another malignancy. Of 39 double primaries of tongue carcinoma, 10 patients (26%) had head and neck malignancies, and none of 26 double primaries of early glottic carcinoma.
Late local recurrence was not rare in tongue and early glottic cancer. Poor prognostic group showed lower incidence of late recurrence than good prognostic group. This result suggests that secondary tumor at the same site of primary tumor is late local recurrence.
背景/目的：舌癌和声门早期癌放疗后的晚期局部复发很少被讨论。在头颈部癌中，约90%的局部复发发生在放疗后2年内。然而，我们发现声门癌放疗后的晚期局部复发并不罕见。我们的目的是评估声门早期癌和舌癌放疗后的晚期局部复发情况。
1967年至1982年期间，大阪大学医院放射科治疗了633例舌癌患者和330例声门早期（T1T2N0）癌患者。在这821例患者中，329例舌癌患者和221例声门早期癌患者放疗后5年存活且无局部复发。对于舌癌，患者按T分期分组。对于声门早期癌，患者按40 Gy时的肿瘤反应分组。
329例舌癌患者中有23例（7%）发生晚期局部复发，221例声门早期癌患者中有9例（4%）发生晚期局部复发。对于舌癌，Ⅰ期和Ⅱ期的249例患者中有19例（8%）发生晚期复发，Ⅲ期和Ⅳ期的80例患者中有4例（5%）发生晚期复发。对于声门癌，40 Gy时肿瘤消退的137例患者中有8例（6%）发生晚期复发，40 Gy时肿瘤持续存在的63例患者中有1例（2%）发生晚期复发。还评估了双原发癌的发生率。329例舌癌5年存活患者中，39例（12%）有另一种恶性肿瘤，221例声门早期癌5年存活患者中有26例（12%）也有另一种恶性肿瘤。在39例舌癌双原发癌中，10例（26%）有头颈部恶性肿瘤，26例声门早期癌双原发癌中无一例有头颈部恶性肿瘤。
舌癌和声门早期癌的晚期局部复发并不罕见。预后较差的组晚期复发发生率低于预后较好的组。这一结果表明，原发肿瘤同一部位的继发肿瘤是晚期局部复发。
