下颌牙龈鳞癌个体化治疗的研究及临床疗效评价

Clinical study of individual treatment on mandible gingivalcarcinoma

目的探讨下颌牙龈鳞癌的个体化治疗方案,评价预后效果。方法以28例下颌牙龈鳞癌为研究对象,根据临床分期及术后淋巴结的转移情况分为三组,分别采取单纯手术、手术加放疗、手术加放疗加辅助化疗,随访3年,观察临床效果并评价预后。结果Ⅰ～Ⅱ期患者采用单纯手术,复发率20%,3年生存率80%;Ⅲ～Ⅳ期淋巴结阴性患者组采用手术加放疗,复发率37.5%,3年生存率75%;Ⅲ～Ⅳ期淋巴结阳性患者,采用手术加放疗加辅助化疗,复发率42.86%,3年生存率71.42%。三组复发率和生存率比较,差异无统计学意义(P>0.05)。结论牙龈鳞癌手术结合放疗完全可以在保存患者功能、外观及生存质量的基础上,取得较为理想的治疗效果,术后化疗的临床疗效尚需进一步研究。

Objective： To evaluate clinical and prognostic effect of individual treatment on mandible gingivalcarcinoma.Methods： Twenty-eight mandible gingivalcarcinoma were treated individually according to TNM stage and local lymphonode status,and survival analysis were performed for patients who received surgery alone,surgery combined with radiotherapy alone or both radiotherapy and chemotherapy.The patients were followed up for more than 3 years.Results： Three groups acquired survival rate of 80.00%,75.00% and 71.42% individually.The differences between three groups had no statistical significance.Conclusion： Surgery combined with radiotherapy is very effective treatment for mandible gingivalcarcinoma.Prognostic effect of chemotherapy still requires further study.