不同治疗方式对颊黏膜鳞状细胞癌的疗效分析  

Effect Analysis of Different Treatments for Patients with Buccal Mucosa Squamous-cell

作　　者：张继青 钟雷 李金娥 唐运章 王虎中 

机构地区：[1]解放军武汉总医院放射治疗科,湖北武汉430070 [2]解放军武汉总医院门诊部,湖北武汉430070 [3]解放军武汉总医院口腔科,湖北武汉430070

出　　处：《华南国防医学杂志》2017年第6期380-382,397,共4页Military Medical Journal of South China

摘　　要：目的观察不同治疗方法对不同分期的颊黏膜鳞状细胞癌的临床疗效。方法对2003-01/2013-12月作者医院收治的80例颊黏膜鳞状细胞癌患者采取不同的治疗方法,其中单纯手术治疗16例,单纯放疗9例,单纯化疗1例,综合治疗(手术+放疗或手术+放疗+化疗或放疗+化疗)54例。结果 5年生存率分别是Ⅰ期60%,Ⅱ期48.28%,Ⅲ期30.30%,Ⅳ期0。局部复发是颊黏膜鳞状细胞癌治疗失败的最主要原因。单纯放射治疗原发灶总剂量70Gy。术后瘤床预防照射剂量60Gy,对术后有残留或切缘阳性者70Gy。结论对于Ⅰ期病例单纯手术或单纯放射治疗取得较高的生存率,Ⅱ、Ⅲ期病例应采用综合治疗,Ⅳ期病例治疗效果不理想。术后放射治疗可以提高颊黏膜鳞状细胞癌的局控率和生存率。Objective To observe the clinical efficacy of different treatments in buccal mucosa squamous-cell carci noma patients of different stages. Methods A total of 80 squamous-cell carcinoma of buccal mucosa patients from authors＇ hospital between January 2003 and December 2013 were retrospectively analyzed, including 16 cases with surgery alone, 9 cases with radiotherapy alone, 1 case with chemotherapy alone, 54 case with comprehensive therapy （surgery ＋ radiotherapy or surgery ＋ radiotherapy ＋ chemotherapy or radiotherapy ＋ chemotherapy）. Results Five years survival rate were calculated., stage I 60%,stage Ⅱ 48. 28%, stage Ⅲ 30. 30%,stageⅣ 0. Local recurrence was the main cause of buccal mucosa carcinoma treatment failure. Primary tumor radiotherapy dose was 70GY, prevention radiation dose for postoperative tumor bed was 60GY, the postoperative residual or positive margin radiation dose was 70GY. Conclusion For stage I patients, surgery or radiotherapy can achieve a higher survival rate, stage Ⅱor Ⅲ patients should adopt combination therapy, the treatment is ineffective for stage IV patients. Postoperative radiotherapy for carci- noma of buccal mucosa can improve local control rates and survival rates of patients.

关 键 词：颊黏膜癌 手术治疗 放射治疗 化学治疗 生存率 

分 类 号：R739.85[医药卫生—肿瘤]