口腔舌鳞状细胞癌的临床分析

Clinical analysis of squamous cell carcinoma of the oral tongue

目的:总结口腔舌鳞状细胞癌的治疗经验以指导临床。方法:回顾性分析1975年1月～2000年12月初次在我院诊治的329例口腔舌鳞状细胞癌患者的临床资料。T1病变82例,T2病变190例,T3病变43例,T4病变14例。综合治疗186例,单纯手术84例,单纯放疗59例。结果:91例患者组织学检查颈部淋巴结转移,其中Ⅰ区淋巴结转移36例,Ⅱ区淋巴结转移65例,Ⅲ区淋巴结转移18例,Ⅳ区淋巴结转移10例。T1病变患者5年和10年累积生存率分别为72.23%和65.21%,T2分别为38.38%和33.11%,T3分别为10.63%和10.63%,T4分别为7.14%和7.14%(P=0.0000,Logrank=75.99)。单纯手术组患者5年和10年累积生存率分别为56.13%和47.28%,单纯放疗组分别为17.49%和17.49%,综合治疗组分别为43.51%和39.04%(P=0.0000,Logrank=42.23)。结论:口腔舌鳞状细胞癌早期病变可考虑单纯手术,而中晚期应给予综合治疗,对中晚期cN0患者可考虑扩大的肩胛舌骨肌上清扫术。

Objective：To evaluate the effect and modality of treatment of oral tongue cancer. Methods：Medical history documents of 329 patients with squarnous cell carcinoma of oral tongue who were initially treated at our institute between January 1975 and December 2000 were retrospectively analyzed. T1 lesion was 82 cases, T2 lesion 190 cases, T3 lesion 43 cases and T4 lesion 14 cases. Combined therapy were 186 cases, surgery alone 84 cases, radiotherapy alone 59 cases. Results：Regional lymph node was histopathologically positive in 91 cases. Among these cases, there were 36 cases at level Ⅰ , 65 cases at level Ⅱ , 18 cases at level Ⅲ, 10 cases at level Ⅳ. 5-and 10-year accumulate survival rate for patients with Tt was 72. 23% and 65.21% respectively, 38. 38% and 33.11% for T2, 10.63% and 10.63% for T3,7. 14% and 7.14% for T4 （ P = 0. 0000, Log-rank = 75.99 ）. S-year and 10-year survival rate for alone surgery was 56. 13% and 47.28% respectively, 17.49% and 17.49% for alone radiotherapy, 43.51% and 39. 04% for combined therapy （ P = 0. 0000, Log-rank = 42. 23 ）. Conclusion： Alone surgery may be considered for the patients with early lesion, combinod therapy for the patients with middle or late lesion. Extended supraomohyoid dissection may be considered for cN0 the patients with middle or late lesion.