RESEARCH FOR IMPROVEMENT OF CURATIVE RATE AND LATE EFFECT IN THE TREATMENT OF ORAL CANCER WITH THE USE OF HYPERFRACTIONATED RADIOTHERAPY.

为评价超分割放射治疗口腔癌的疗效，进行了一项临床试验。21例未经治疗并经活检证实的口腔鳞状细胞癌患者参加了这项研究。两年生存率高达66.7%，这是因为T1或T2肿瘤的患者多于T3或T4肿瘤患者，也是因为挽救手术效果良好。然而，没有任何变量可以使超分割放射治疗的生存率提高。肿瘤大小对局部控制率有影响。肿瘤分期低的患者控制率较高，从器官保护的角度考虑，小体积的肿瘤或颊癌可作为超分割放疗的适应证。相反，晚期疾病的控制率与公布的数据相同。…总剂量和联合化疗方案的改进更多的可能是一个应该尽快披露的话题。急性粘膜反应程度较常规分级严重。然而，据估计，它是可以耐受的，不需要在治疗中进行任何分裂。晚期反应发生率较低，可能与随访时间较短有关，但建议对患者进行严密的口腔管理。根据本试验的结果，我们试图比较单纯超分割放射治疗和超分割放射治疗与化疗联合治疗的初步结果，为今后的临床治疗提供参考。单纯超分割放射治疗的局部控制率提高不明显，而化疗联合超分割放射治疗可改善局部控制率。虽然联合化疗的临床优势和更好的联合治疗方式尚未显现，但我们认为联合化疗将是提高治愈率的实际选择。较少

To estimate the efficacy of hyperfractionated radiotherapy for oral cancer, a clinical trial was conducted. Twenty one patients with previously untreated and biopsy-proven squamous cell carcinoma ofhe oral cavity were entered in this study. Two-year survival rate was high, 66.7% because there were more patients with T1 or T2 tumor than those with T3 or T4 tumor and also because salvage surgery worked well. However, there was not any variable which made a survival rate to improve using hyperfractionated radiotherapy. Local control rate was influenced by the size of tumor. A higher control rate was obtained in the patients with lower stages of tumor, and it was considered from the stad point of organ preservation that a small size of gaingival or buccal carcinoma would be involved in indications for hyperfractionated radiotherapy. On the contrary, a control rate of advanced diseases was the same as that of published data. Modifications of a total dose and a combination of chemotherapy wo … More uld be a subject which should be disclosed as quickly as possible. The grade of acute mucosal reaction was severer than that in the conventional fractionation. It was, however, estimated as tolerable and any split in the treatment was not needed. The incidence of late reactions was low, possibly due to a shorter period of follow-up, but it was suggested that the close management of the whole oral cavity was necessary in the patients.From these findings in the trial, we tried to compare preliminary results between the treatment with hyperfractionated radiotherapy alone and the combined treatment of hyperfracionated radiotherapy and chemotherapy for the development of a clinical management in the future. Local control rates were improved unsuccessfully when hyperfractionated radiotherapy alone was used, but those were improved when chemotherapy was used with a combination of hyperfractionated radiotherapy. Although a clinical advantage of the combination of chemotherapy and a better mode of the combination have not shown yet, we consider that the combination of chemotherapy would be an actual choice to obtain an improvement of therapeutic ratio. Less