不同放射治疗方法及组织学类型对皮肤恶性肿瘤生存率的影响

Effects of radiation therapy methods and histology types on survival rateofskin cancer

为了探讨不同治疗方法及组织学类型对皮肤恶性肿瘤治疗效果的影响。对我院１９７７年到１９９２年治疗的可供分析的７２例皮肤及附件恶性肿瘤就治疗方法，组织学类型，照射总剂量及分割剂量，照射野大小等与５年，１０年生存病例数及生存率的关系进行分析研究。结果表明：皮肤恶性肿瘤总的放射治疗失败率为２６．４％（１９／７２），１４例基底细胞癌采用单次剂量３．０～３．５Ｇｙ组５年，１０年生存率分别为７８．５％。７０．０％；常规剂量组５年，１０年生存率分别为７９．８％，６２．９％。在４９例基底细胞癌中，５年，１０年生存率综合治疗组为８６．４％，５０％，单纯放疗组为８５．２％，４８．０％；照射野超过肿瘤边缘大于２ｃｍ组分别为６９．２％，４０．４％；超边小于２ｃｍ组为８８．０％，２９．２％。基底细胞癌生存率较其他肿瘤高，单次剂量以３．０～４．０Ｇｙ治疗效果较好，综合治疗组与单纯放疗组以及照射野超过肿瘤边缘大于２ｃｍ组和超边小于２ｃｍ组５年，１０年生存率经统计学处理，无显著性差异。基底细胞癌放疗照射总剂量以５１～６０Ｇｖ最佳。

To evaluate effects of radiation therapy methods and histology types on survival rate of skin cancer. 72 casesof skin cancer were treated by radiation therapy from 1977 to 1992. Relation between different therapy methods,histology type, total radiation dose, fractionated dose and survival rate was studied. Total dose was from 3.5 to 8.5Gy. 19 patients died of the reason related to skin cancer. The 5 year and 10 year survival rates:Basal cellcarcinoma was 87.8 % ,63.2 % , squamous cell carcinoma was 57.1 % , 30.1 % , Basal cell carcinoma for 3.0-3.5Gy offractionated dose was 78.5 % , 70.0% , for routine fractionated dose was 79.8 % , 62.9 % , for irradiated field>2cm ofedge of tumor was 69.2% ,40.4%, for that<2cm was 88.0%,29.2%. 5 and 10 years survival rates of Basal cellcarcinoma were higher than those of squamous cell carcinoma(P<0.05). It was optimal that fractionated dose ofper day was 3.0￣3.5Gy. With total radiation dose of 51￣60Gy