ｓｔａｇｅＩ・ＩＩ舌癌の治療成績について

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  • Clinical Results in Stage I II Cancer of the Tongue.

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Reconstruction surgery, is being used increasingly to treat large T3 and T4 cancers of the tongue. For small T1 and T2 tumors, treatment is roughly divided into partial resection and a sealed small radiation source. We have been treating patients with cancer of the tongue since 1946. Primary lesions were mainly treated by a radium small radiation source until the early 1980 s. Clinical results from 1946 to 1970 were not satisfactory, with 5-year-survival being T1 : 69.9% (N=136) and T2 : 52.9% (N=231). Because calculation of radiation dose distribution using a computer was introduced and also because dissection of the neck was conducted positively against cervical lynphnode metastasis, 5-year-survival from 1971 to 1980 improved to T1 : 79.2% (N=63) and T2 : 69.0% (N=78). In 1982, the number of surgical cases increased gradually even for Tl and T2 as reconstruction using a skin flap was begun. In 1994, treatment with a small radiation source was abolished with closure of the radiation control ward. After that, we conducted treatment based mainly on partial resection. Subjects were 283 patients with stage I and II squamous cell carcinoina of the tongue who underwent radical therapy from January 1982 to December 1996, classified by therapy. In the small radiation source group, local recurrence, neck recurrence, and 5-year-cumulative survival by the Kaplan-Meier method were 15.5%, 39.7%, and 84.5% in stage I (N=58) and 15.5%, 43.1%, and 74.1% in stage 11 (N=58). In the surgically treated group, they were 14.7%, 21.3%, and 74.5% in stage I (N=75) and 14.3%, 40.5%, and 78.0% in stage II (N=42). No significant difference was found in results by to therapy. In the integrated treatment groups, 5-year-cumulative survival in stage I was 78.3% (N=143) and in stage II 71.2% (N=140).

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