RADIATION-THERAPY FOR SQUAMOUS-CELL CARCINOMA OF THE SKIN
RADIATION-THERAPY FOR SQUAMOUS-CELL CARCINOMA OF THE SKIN
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DOI：
10.1097/00000421-199110000-00004
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发表时间：
1991-10-01
影响因子：
2.6
通讯作者：
WILDER, RB
中科院分区：
文献类型：
--
作者：
SHIMM, DS;WILDER, RB
本文回顾了85例鳞状细胞皮肤癌放射治疗的临床资料，其中原发灶23例，复发灶6例，同期或异时转移灶16例，其中前两组3例。5年精算局部控制率分别为0.54、0.0、0.42和0.79。未显示局部控制与肿瘤大小或放射剂量之间的关系。在32例局部失败中，有7例尝试了挽救治疗，其中4例成功。发生在既往放疗、肾移植、血液系统恶性肿瘤或慢性炎症的癌症没有恶化，而腮腺淋巴结转移的患者一般在联合放疗和手术的情况下进展较好。手术后辅助性放疗提供了0.79的5年疾病控制率。对于未经治疗的原发灶、复发的原发灶或未经治疗的结节转移灶，单纯放射治疗可提供约0.50的疾病控制概率。局部或全身的易感因素并不能提供明显不同的预后。腮腺淋巴结转移最好采用综合治疗。
Eighty-five squamous cell skin cancers treated with radiation therapy were reviewed, including 23 untreated primary tumors, 6 recurrent tumors, 16 synchronous or metachronous nodal metastases including 3 patients from the previous two groups, and 38 sites irradiated for microscopic residual cancer after surgery. The 5-year actuarial local controls were 0.54, 0.0, 0.42, and 0.79, respectively. No relationship between local control and either tumor size or radiation dose could be shown. Salvage treatment was attempted in 7 of 32 local failures, and has been successful in 4. Cancers arising in the settings of prior irradiation, renal transplant, hematopoietic malignancies, or chronic inflammation did not fare worse, and patients with parotid node metastases generally fared better with combined irradiation and surgery.Surgery followed by adjuvant irradiation confers a 5-year disease control probability of 0.79. Irradiation alone for untreated primary lesions, for recurrent primary lesions, or for untreated nodal metastases confers a disease control probability of approximately 0.50. Local or systemic predisposing factors do not confer an appreciably different prognosis. Parotid lymph node metastases are best served by combined modality treatment.