舌癌662例远期疗效观察

LONG TERM RESULTS OF THE TREATMENT OF TGONGUE CANCER——REPORT ON 662 CASES

自1964年3月到1984年7日共收治经病理证实的舌癌662例。其中男415例(62.7％),女247例(37.3％)。男:女=18:1。年龄最小4岁,最大84岁。主要症状有舌肿块、舌痛、舌溃疡等。鳞状细胞癌632例(占95.5％)。主要治疗方法有:①计划性综合治疗组(即外放射治疗+镭针插植+颈淋巴结清除术)。②舌癌联合根治术组。③单纯镭针插植组。④单纯外放射治疗组。⑤其它治疗组。总的疗效:3、5、10年生存率分别为57.1％、53.1％、43.8％。Ⅰ、Ⅱ、Ⅲ、Ⅳ期的5年生存率分别为77.3％、60.2％、47.3％和44.8％。计划性综合治疗组、联合根治组、镭针插植组、外放射治疗组和其它方法治疗组的5年生存率分别为63.3％、58％、44.7％、22.7％和29.4％。计划性综合治疗组的肿瘤放射量应7000～9000CGY为宜。本组病例的颈淋巴结转移率为34.9％。有颈淋巴结转移者5年生存率为30.6％,无颈淋巴结转移者5年生存率为73.3％。笔者认为:①计划性综合治疗组的治疗方法是舌活动部分癌的首选治疗方式。②舌活动部分癌的颈淋巴结转移率高而且对放射治疗不敏感,故应作选择性的颈淋巴结清除术。

662 cases of tongue carcinoma were treated in our hospital from March1964 to July 1984. Among the 662 cases. 415(62.7%) were male, 247 (37.3%) were female. The sex ratio (M:F) was 1,8 : 1. The youngest was 4 years old, white the oldest was 84. The primary symptoms were mass of the tongue, glossodyknia and ulceration- Among them 632 cases(95.%) were squamous cell carcinoma. The predominant therapeutic modalities were as follows : (1) The planned surgery irradiation combined treatment (included radiotherapy plus interstitial therpy plus radical neck node dissection); (2) The classical hemiglossectomy plus radical neck node dissection; (3) Interstitial therapy with radium needles alone; (4) Radiotherapy alone; (5) Other modality. The overall 3,5, 10-year survvival rates of stages Ⅰ. Ⅱ. Ⅲ, and Ⅳ cases were 77.3%, 60.2%, 47.3%and 44.8%, respectively . According to the different therapeutic methods, the 5-year survival rates was 63.3%for group (1):58% for group (2): 44.7%for group (3). 22.7%for group (4); 29.4%for group( 5 ), Dose of tumor irradiatin on of the planned combined treatment should be 7000-9000CGv . The incidence of cervical lymph node metastases was 34.9%. The 5-year survival rates were 30.6% for those with positive cervical lymph nodes; 73.3%for lymph node negative cases- The authors believe that: (1)The planned coml'ined treatment is a fairly satisfatorv therapeutic modality for ton gue carcinoma. (2) Radical neck node dissection should be performed, because the carci-noma of the mobile tongue has high incidence of lymnh node matastases and thev are low radiosensitive