Management of Advanced BCC with Radiotherapy-Case Report

以放射治療處理後期基底細胞癌－案例報告

張耀元(Yao-Yuan Chang) ； 董光義(Kwang-Yi Tung) ； 蘇文浩(We-Hao Su) ； 黃文成(Wen-Chen Huang)

《中華民國癌症醫學會雜誌》 22卷4期 (2006/12) Pp. 10-14

https://doi.org/10.6588/JCOS.2006.22.4.2

摘要

基底細胞癌(BCC)，是最常見的人類惡性腫瘤，最常發現於陽光暴露的皮膚。頭頸部是最好發的部位。皮膚基底細胞癌的發生率，每年全世界約有10%的成長率。
第一線皮膚基底細胞癌的治療方法往往是手術切除，也有多替代方法。廣泛切除會有最低的復發率，但復發率會受到手術切除後，是不是有足夠的安全範圍所影響。
此外，選擇手術切除前，還有一些重要的安全和生活質量的問題必須考慮。患者的年齡和健康狀況會增加相關的風險（如出血和感染）。病人同時也會關心美觀問題。因此，越少的侵入性治療則更為理想。
放射治療是一個有用的手術替代性療法。它對於治療老年患者、較大腫瘤、或難以處理的位置（如眼瞼或耳朵），特別有用。
在我們的病例中，腫瘤大小約6*3公分，位於右邊耳朵鄰近的位置。我們選擇對這位病人只使用放射治療，十年的追蹤結果是完全治愈、無復發、且具有良好的外觀。

並列摘要

Basal cell carcinoma (BCC) is the most common human malignant neoplasm, and most commonly observed in sun-exposed areas of skin. Head and neck region are the most common sites of involvement. The incidence of BCC is increasing worldwide by up to 10% per year.
The first line treatment of BCC is often surgical excision with many alternatives available. Wide excision results in the lowest rate of recurrence, but the recurrence rate after surgical excision is affected by the incomplete excision of tumor margins.
In addition, there are important safety and quality of life issues that should be considered before selecting surgical excision. Increased associated risks (e.g. bleeding and infecion) may related to patient age and health status. Cosmetic issues are also concerned by patients. Therefore, less invasive procedures are desired to treat the nroplasm.
Radiotherapy has been a useful alternative to surgical treatments. It has been particularly useful in the treatment of elderly patients and for larger tumors or tumors in difficult-to-treat locations, such as the eyelids or the ear. In our case, the tumor size was about 6*3 cm located over R't periauricular region. We chose radiotherapy alone for this patient and resulted in complete cure without recurrence with good cosmetic outcome for 10 years.