Assessment of Influence of Smoking, Drinking, Leukoplakia and Dental Irritation on Local Control of Early Oral Tongue Carcinoma Treated with Brachytherapy: Age and Dental Factors are Potential Prognostic Factors
Assessment of Influence of Smoking, Drinking, Leukoplakia and Dental Irritation on Local Control of Early Oral Tongue Carcinoma Treated with Brachytherapy: Age and Dental Factors are Potential Prognostic Factors
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吸烟、饮酒、白斑和牙齿刺激对近距离放射治疗早期口腔舌癌局部控制的影响评估：年龄和牙齿因素是潜在的预后因素
作者：
H. Yamazaki;Takehiro Inoue;Ken Yoshida;T. Kotsuma;Y. Yoshioka;M. Koizumi;S. Furukawa;N. Kakimoto;K. Shimizutani;T. Nishimura
背景研究淋巴结阴性移动的舌癌（T1- 2N 0 M0）老年患者（65岁或以上）的背景特征，这些患者的局部控制比年轻组差。材料与方法回顾性分析了1967年至1999年间265例近距离放射治疗伴或不伴外照射患者的背景资料。我们检查了牙科因素（如假体刺激），白斑，吸烟和饮酒，以比较老年人（年龄≥65岁; n = 83）和对照组（64岁或以下; n = 182）。结果老年组5年生存率为86%，明显低于对照组的70%（P <0.05）。老年患者的牙科因素发生率（53%）高于对照组（40%，P = 0.07）。牙科因素被证明对局部控制具有预后重要性。5年局部控制率为85%的患者和76%的患者无牙科因素（P = 0.04）。牙科因素阳性的老年组5年局部控制率（61%）低于其他3组[无牙科因素（-）老年组（80%），对照组有牙科因素（+）老年组（84%），对照组无牙科因素（-）老年组（87%）]（P <0.05）。对照组（23%）的白斑发生率高于老年组（5%）（P = 0.006），但对治疗结果无影响。结论年龄和牙齿因素（包括假体刺激）是口腔舌癌近距离放射治疗局部控制的潜在重要预后因素，尤其是老年患者。
Background To examine the background characteristics of elderly patients (65 years or older) with node-negative mobile tongue cancer (T1-2N0M0) who showed worse local control than a younger group. Materials and methods We retrospectively analyzed background data for 265 patients treated with brachytherapy with or without external radiotherapy between 1967 and 1999. We examined dental factors (such as irritation by prosthesis), leukoplakia, tobacco smoking and alcohol consumption for comparisons between the elderly (age ≥65 years; n = 83) and a control group (64 years or younger; n = 182). Results The elderly patients showed a worse outcome than the control group (respectively 86% and 70% at 5 years; P <0.05). Incidence of dental factors tended to be higher for elderly patients (53%) than the control group (40%, P = 0.07). Dental factors proved to have prognostic importance for local control. Five-year local control rate was 85% for patients with and 76% for patients without dental factors (P = 0.04). The elderly group positive for dental factors showed a lower 5-year local control rate (61%) than the other three groups [(elderly without the dental factor (–) group (80%), control with the dental factor (+) group (84%), and control without the dental factor (–) group (87%)] (P <0.05). Leukoplakia was found more frequently in the control (23%) than in the elderly group (5%) (P = 0.006) but had no effect on treatment outcome. Conclusions Age and dental factors (including prosthesis irritation) are potentially important prognostic factors for local control of oral tongue cancer treated with brachytherapy, especially for elderly patients.