摘要
目的 探讨老年人口腔颌面部恶性肿瘤的发病、治疗和预后 ,为临床诊治提供依据。 方法 对日本九州大学齿学部第二口腔外科 1987年 1月至 1995年 12月住院治疗的老年口腔颌面部恶性肿瘤患者进行回顾性分析。 结果 老年口腔颌面部恶性肿瘤患者共 14 8例 ,男性 77例 ,女性71例 ;年龄 6 0~ 94岁 ,平均 72 2岁。入院时发生频率最高的并存症是高血压 4 3例 ,占 2 9 1% ;无任何全身并存症的患者仅占 12 8%。 14 8例恶性肿瘤中 ,鳞状上皮癌 132例 ,占 89 2 %。其发病部位顺序为牙龈 5 1例 (34 5 % )、舌 32例 (2 1 6 % )、口底部 2 4例 (16 2 % )、颊部 17例 (11 5 % )、腭部 10例(6 8% )。 4 6例StageIV期患者中 ,肿瘤部位有义齿者 35例 ,占 76 1%。发现重复癌 10例 (6 8% ) ,男女比为 1 5∶1。 3年累计生存率 78 2 % ,5年累计生存率 6 4 6 %。行放射疗法 +化学疗法 +手术的综合疗法治疗者 6 8例 ,5年生存率为 75 5 %。 结论 老年患者近 90 %患有全身并存症 ;不良义齿、金属充填物等长期局部刺激与口腔癌的发病有一定的关系 ;老年人重复癌发病率逐年升高 ,应进行长期追踪观察 ;综合疗法疗效较好。
Objective To provide references for further clinical treatment of the oral and maxillofacial neoplasms by analysing the prevalence, treatment and prognosis of the diseases in Japanese elderly. Methods 148 elderly patients with malignant neoplasms at oral and maxillofacial regions were investigated retrospectively. All patients were treated in the second department of oral and maxillofacial surgery, the dental faculty of Kyushu University in Japan between January 1987 and December 1995. Results A total of 148 cases(77 male and 71 female, aged 60-94 years, averaged 72 2 years) were included in this study. Among all patients, hypertension was the commonest illness. Only 12 8% of them was not accompanied by common systemic diseases. Out of 148 neoplasms, 132 cases (89 2%) was pathologically diagnosed squamous cell carcinoma and located at gingival(34 5%), tongue(21 6%), floor of mouth(16 2%), buccal (11 5%) and palate(6 8%) regions, respectively. Out of 46 Stage Ⅳ cases denture was seen at the tumor tissue in 35 patients. Multiple primary cancers were observed in 10 patients(male to female was 1 5∶1). The 3 year survival rate was 78 2%, 5 year survival rate was 64 6%. By combination therapy of irradiation, anti cancer drugs and surgery, 5 year survival rate of 68 cases was enhanced to 75 5%. Conclusions Nearly 90% of the elderly patients was complicated with systemic diseases. The occurrence of oral and maxillofacial neoplasms showed some relationships with bad denture and metal filling. Longer observation is necessary for the multiple primary cancer cases. The combination therapy of irradiation, drug and surgery is better for the treatment of oral and maxillofacial neoplasms in the elderly.
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2001年第6期441-443,共3页
Chinese Journal of Geriatrics