Cowen D, Essomba M, Richaud P, Renaud-Salis J L, Pigneux J
Service de radiothérapie, Fondation Bergonié, Bordeaux, France.
Bull Cancer Radiother. 1990;77(2):111-7.
From 1970 to 1985, 299 patients with lip cancer were examined, treated and followed-up at the Bergonié Foundation. In most cases, interstitial radiotherapy was used and the local control rate reached 94%. Local recurrences could usually be treated again, so that the final local control rate was 99%. However, the management of neck nodes remains controversial in some cases: 5.6% only of T1-2 N0 stages developed neck nodes, which were successfully controlled in 78.9% of cases and it was therefore considered that the preferred option should be to maintain the patients under close follow-up. For T3 N0 cases, of which 17.6% would evolve, it was considered that a sub-mental and sub-maxillary neck node dissection was advisable when performance status was satisfactory and when a close follow-up was difficult. The recurrence rate was 40% for patients with palpable neck nodes who were often submitted to a combined radio-surgical treatment. In such cases, recurrences were controlled in 22% of patients who died 7 times out of nine.
1970年至1985年期间,贝戈涅基金会对299例唇癌患者进行了检查、治疗和随访。在大多数情况下,采用了间质放疗,局部控制率达到94%。局部复发通常可以再次治疗,因此最终局部控制率为99%。然而,在某些情况下,颈部淋巴结的处理仍存在争议:T1-2 N0期仅有5.6%出现颈部淋巴结,其中78.9%的病例得到成功控制,因此认为首选方案应为对患者进行密切随访。对于T3 N0病例,其中17.6%会进展,当患者身体状况良好且难以进行密切随访时,建议进行颏下和颌下颈部淋巴结清扫。对于经常接受放疗联合手术治疗的可触及颈部淋巴结患者,复发率为40%。在这些病例中,22%的患者复发得到控制,其中九分之七的患者死亡。