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

为了评估高分割放疗治疗口腔癌的疗效，进行了一项临床试验。本研究纳入了21例未经治疗并经活检证实的口腔鳞状细胞癌患者。2年生存率高，为66.7%，这是因为T1或T2肿瘤患者多于T3或T4肿瘤患者，并且挽救手术效果良好。然而，没有任何变量使得使用高分割放疗提高生存率。局部控制率受肿瘤大小的影响。肿瘤分期较低的患者控制率较高，从器官保存的角度考虑，小尺寸的龈癌或颊癌可能涉及到高分割放疗的指征。相反，晚期疾病控制率与公布的数据相同。总剂量的改变和化疗的组合……更多的是应该尽快披露的问题。急性粘膜反应的程度较常规分馏法严重。然而，据估计，这是可以忍受的，治疗中不需要任何分裂。晚期反应的发生率较低，可能是由于随访时间较短，但建议对患者进行全口腔的严密管理。根据试验结果，我们试图比较单纯高分割放疗与高分割放疗和化疗联合治疗的初步结果，以便将来制定临床治疗方案。局部控制率在单独使用高分割放疗时没有得到改善，但当化疗与高分割放疗联合使用时，这些控制率得到了改善。虽然联合化疗的临床优势和更好的联合方式尚未显现，但我们认为联合化疗将是获得治疗比提高的现实选择。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