小於四十歲的舌癌患者之治療結果

Treatment Results of Tongue Cancer in Patient Younger than 40 Years Old

范綱行(Kang-Hsing Fan) ； 曾振淦(Chen-Kan Tseng) ； 白冰清(Ping-Ching Pai) ； 曾雁明(Ngan-Ming Tsang) ； 洪志宏(Ji-Hong Hong)

《放射治療與腫瘤學》 10卷4期 (2003/12) Pp. 219-228

https://doi.org/10.6316/TRO/200310(4)219

摘要

目的：分析本院過去對於年齡小於40歲的舌癌患者其治療結果。
方法和材料：自1990年一月至1999年9月期間，共有35名年齡小於40歲的舌癌病患在林口長庚紀念醫院接受放射線治療。所有存活的病人都至少追蹤3年以上，而所有病人平均的追蹤時間為1.35年。
所有的病人都接受了體外放射線治療（至少60 Gy），其中28位是屬於手術後追加治療。其中有六位病人因拒絕開刀或是因故不能開刀，只接受放射治療。一位則是在放射治療後復發，再度接受開刀治療。治療的結果用下列因子分析: 治療前的習性，腫瘤分期，以及治療方式等。
結果：全部病人的三年的總存活率及無疾病存活率為42.8%及48.2%。在排除沒有以開刀為第一治療的病人後，三年的總存活率及無疾病存活率為50%及57.6%。所有病人及先以外科開刀治療之病人兩者的存活時間中位數各為1.42及3.26年。七例未將外科開刀列為首選治療者，有六例未能達到成功的局部控制，而且都在16個月內死亡。另一例在接受前導性化學治療及同步放射及化學治療後得到完全緩解，但3.7年後發生局部復發。單變數分析顯示以開刀為第一治療，腫瘤分期晚期（第三或第四期），以及病理組織型態會影響病人的預後。但是多變數分析僅有分化不良的組織型態有顯著意義。
結論：和文獻上一般病人族群的治療結果比較後，我們的治療結果並沒有顯著的差異。另外，手術應是小於四十歲舌癌患者的第一優先治療選擇。

關鍵字

舌癌 ； 年輕 ； 放射治療

並列摘要

Purpose : To evaluate treatment outcomes in patients under 40 years of age with cancer of the mobile tongue.
Method and Materials : Between January 1990 and September 1999, 35 patients under 40 years of age suffering from mobile tongue cancers were treated at the LinKou Chang-Gung Memorial Hospital (LK-CGMH). External beam radiotherapy was used as either adjuvant management after surgery or primary treatment. All patients were followed for at least three years or until death. Median follow-up was 1.35 years.
External radiotherapy of at least 60 Gy was administered to all patients. Twenty-eight patients received adjuvant radiotherapy. Six people who refused or were unsuitable for surgery were treated with radiotherapy only. One patient underwent radiotherapy as primary therapy but required surgical salvage after recurrence. The treatment results were analyzed, as were pre-treatment habits, tumor staging, and treatment modalities.
Results : The three-year overall survival and disease-specific survival rates for the group were 42.8%, and 48.2%, respectively. After excluding patients who chose not to undergo surgery as primary treatment, the rates were 50% and 57.6%. The median survival of all patients and patients who received primary surgery was 1.42 and 3.26 years, respectively. In all patients who did not undergo surgery as primary treatment, tongue tumor control was not achieved, and all died within 16 months, except for one who experienced complete remission after induction chemotherapy and concurrent chemo-radiation. Univariate analysis indicated that primary surgery, 1997 AJCC staging group III or IV and histological differentiation significantly affected overall survival. Multivariate analysis found that poor histological differentiation was the only significant factor affecting overall survival.
Conclusions : These findings concur with those of other series for the age group studied. Surgery continues to be the first-line, primary treatment for patients under 40 years of age with cancer of the mobile tongue.

並列關鍵字

Tongue cancer ； Young age ； Radiotherapy