127例原发齿龈鳞状细胞癌预后分析

Prognostic Analysis on 127 Patients with Squamous Cell Carcinoma of the Gingiva

目的:探讨原发齿龈鳞状细胞癌最佳治疗方法及影响预后的因素。方法:分析我院1978年1月至1998年12月收治的127例原发齿龈鳞状细胞癌患者,观察其临床疗效。结果:127例中单纯手术18例,单纯放疗37例,术后放疗9例,术前放疗22例,化疗加手术31例,姑息化疗10例;5年生存率分别为27.5%、20.4%、66.7%、72.7%、50.2%和0。结论:齿龈鳞状细胞癌首选手术治疗,放疗和(或)化疗,是预防单纯手术后复发或放疗后局部未控的有效方法。综合治疗可以提高齿龈鳞状细胞癌的预后;影响预后的主要因素有治疗方法、分期、淋巴结转移和发病部位等。

Objective: To investigate the optimized treatment and the factors about prognosis of squamous cell carcinoma of the gingival. Methods: A retrospective study was conducted in 127 cases with squamous cell carcinoma of the gingival hospitalized from January 1978 to December 1998. All patients were followed for 5 years and divided into 6 groups according to the treatment: operation alone; radiotherapy only; operation and radiotherapy sequentially; radiotherapy and operation sequentially; chemotherapy and operation sequentially and palliative chemotherapy. Results: Of the 127 patients with squamous cell carcinoma 18 cases received operation alone; 37 cases only received radiotherapy; 9 cases received operation and radiotherapy sequentially; 22 cases received radiotherapy and operation sequentially; 31 cases received chemotherapy and operation sequentially and 10 cases received palliative chemotherapy. The 5 years survival rates of the 6 groups are 27.5%?20.4%?66.7%?72.7%?50.2% and 0% respectively. Conclusions: Operation is the first scheme for the treatment of squamous cell carcinoma of the gingival; accompanied with radiotherapy and/or chemotherapy is a effective method for the control of local failure after radiotherapy and recurrence after operation; combination therapy is helpful for the prognosis of squamous cell carcinoma of the gingival. The methods of treatment, staging, metastasis of the lymph node and site of the primary disease play an important role in the prognosis of squamous cell carcinoma of the gingival.