FAILURE AT THE PRIMARY SITE FOLLOWING MULTIMODALITY TREATMENT IN ADVANCED HEAD AND NECK-CANCER
FAILURE AT THE PRIMARY SITE FOLLOWING MULTIMODALITY TREATMENT IN ADVANCED HEAD AND NECK-CANCER
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DOI：
10.1002/hed.2890060303
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发表时间：
1984-01-01
期刊：
影响因子：
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通讯作者：
SPIRO, R
中科院分区：
文献类型：
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作者：
VIKRAM, B;STRONG, EW;SPIRO, R
原发部位复发是头颈部恶性肿瘤发病率和死亡率的重要原因。1960-1970年间，在纪念斯隆-凯特琳癌症中心[纽约，纽约，美国]接受手术治疗的III期和IV期疾病患者中，即使边缘被认为令人满意，仍有39%的原发部位癌症复发，而当边缘不满意时，复发率为73%。在1975-1980年期间，114例未经治疗的口腔、口咽、下咽或喉的III期和IV期表皮样癌患者接受了手术和术后放射治疗的联合治疗。27例患者还接受了术前化疗[基于顺铂]。共有107例患者通过联合治疗在原发部位可评价疾病控制。6例患者的原发部位复发，其中2%的47例患者手术切缘满意，10.5%的60例患者手术切缘不满意。在后者中，25例边缘< 5 mm但显微镜下未受累的患者中有5%复发，35例边缘显微镜下被癌症累及的患者中有15%复发。这些数据与历史对照组的比较表明，多模式治疗的原发部位失败率降低。然而，为了获得最佳结果，确保显微镜下阴性边缘似乎仍然很重要。
Recurrence at the primary site is an important cause of morbidity and mortality in head and neck cancer. In patients with stages III and IV disease treated surgically at Memorial Sloan-Kettering Cancer Center [New York, New York, USA] between 1960-1970, cancer recurred at the primary site in 39% even when the margins had been deemed satisfactory, and in 73% when the margins were unsatisfactory. Between 1975-1980, 114 previously untreated patients with stages III and IV epidermoid carcinoma of the oral cavity, oropharynx, hypopharynx or larynx were treated with a combination of surgery and postoperative radiation therapy. Twenty-seven patients also received preoperative chemotherapy [based on cis-platinum]. A total of 107 patients were evaluable for disease control at the primary site by the combined treatment. Cancer recurred at the primary site in 6 patients, including 2% of 47 patients whose surgical margins had been satisfactory and 10.5% of 60 patients whose surgical margins had been unsatisfactory. Of the latter, recurrence was seen in 5% of the 25 patients whose margins were < 5 mm but were microscopically uninvolved, and in 15% of the 35 patients whose margins were microscopically involved by cancer. Comparison of these data with the historical control group suggests a decrease in the failure rate at the primary site with multimodality treatment. However, it still appears important to secure microscopically negative margins for the best results.