头面部皮肤癌放射治疗效果分析

RADIATION THERAPY OF SKIN CANCER IN THE FACE AND SCALP

皮肤癌在我国不多见。对经过选择的病例,手术切除、放射治疗、激光或冷冻等不同治疗方式都能获得较好疗效,但是对头面部皮肤癌的治疗,除首先考虑病灶控制之外,还较多地考虑功能和美容问题。放射治疗常能达到这两个目的,因此在治疗上有其特殊性。

310 cases of face and scalp skin cancer were treated by radiation therapy from 1975 to 1984. Histology types, basal cell carcinoma 163 cases, squamous cell carcinoma 134 cases, mixed basal and squamous cell carcinoma and other cancers 13 cases. Tumor sitest nose 86 cases, eyelid 70 cases, other parts of face 130 cases, ear lobe or scalp 24 cases. Most patients were treated with orthovol-tage X-ray with doses ranging from 3500-7000 cGy /4-40 F. The overall 5 and 10 year survival rates were 77.7% and 63.3%, respectively. The major factors influencing the treatment results were histological type and tumor size. The 5 year survival rate of basal cell carcinoma was higher than that of squamous cell carcinoma (87.1% vs 65.7%). The 5-year survival rate of patients with tumor < 3 cm and≥ 3 cm were 82.3% and 65.7%, respectively (p<0.01) . 45 patients died from causes related to skin cancer. A linear relationship between fractionation number and total dose was found in patients alive. The possible relationship between time, dose and fractions is discussed.