Local Regional Relapse Patterns Following Ipsilateral Postoperative Adjuvant Radiotherapy for Buccal Cancer

頰癌病患接受同側術後輔助性放療之局部復發情形探討

簡君儒(Chun-Ru Chien) ； 丁禮莉(Lai-Lei Ting) ； 鍾娜娜(Na-Na Chung) ； 雷德(Louis-Tak Lui)

《中華放射線醫學雜誌》 28卷1期 (2003/02) Pp. 9-15

摘要

研究頰癌經同側術後輔助性放療之局部復發模式，以協助決定術後輔助性放療之適當靶體積。
自1991-1999，共收集連續46位因原發性頰癌於本院接受完整同側術後輔助性放療（以電腦做治療計畫）之病人。通常以臨床上及術後電腦斷層上對側頸部正常者為接受同側放療之原則。共有43位男性及3位女性，中位年齡為52歲。多數病人為第三或第四期（41/46）。腫瘤床處之中位放療劑量為60格雷（範圍：50-70格雷）。
在中位追蹤20個月後（範圍：2-101個月）共有25個病人發生34處局部復發（同側：雙測：對側：其他=19：3：2：1）。期別（T4N2-3，4/11=36%）為最可能導致對側復發之危險因子。
除高危險性之頰癌病患外，術後輔助性放療可以治療同側為原則。

關鍵字

頰鱗狀細胞癌 ； 腫瘤局部復發 ； 放射治療

並列摘要

To study the initial local regional relapse (iLRR) patterns following ipsilateral postoperative adjuvant radiotherapy (iPART) for primary buccal cancer as an aid in defining the clinical target volume (CTV) for buccal cancer.
From June 1991 through April 1999, forty-six patients with localized primary squamous cell carcinoma of the buccal/gingival mucosa were treated with complete iPART with two dimensional (2D) planning technique (generally due to negative clinical/imaging exam of contralateral neck). The median age of these 43 men and 3 women was 58 years. Stage III/IV cases composed the majority of the study group (41/46). The median dose at tumor bed was 60 Gy with range of 50-70Gy. Eight patients received chemotherapy.
After a median follow-up of 20 months (2-101 months), twenty-fie patients had thirty-four iLRR (ipsilateral vs both side vs. contralateral only vs other =19 vs.3 vs.2 vs.1). Advanced stage (T4N2-3, 4/11 =36%) was the most possible risk factor with statistical significance for contralateral iLRR. The risk of contralateral iLRR was 3% in non-T4N2-3 patients.
It might be appropriate to perform iPART only for non high-risk buccal cancer patients.

並列關鍵字

Buccal Carcinoma ； Local recurrence ； Radiotherapy