头面部皮肤鳞癌的治疗

目的 分析头面部皮肤鳞癌手术治疗加辅助放疗的效果，总结和探讨其治疗的方法和经验。方法 1998年1月～2002年12月，对37例头面部皮肤鳞癌患者行手术加辅助放疗治疗。手术根据肿瘤的分期决定切除范围，并根据切除范围和周边组织活动度分别采用一期直接缝合、二期游离植皮、一期游离植皮3种方案。术后放疗剂量60～65Gy／6～7周。随访截止于2004年6月。结果 术后37例获随访5～69个月，中位时间38个月，失访3例。有4例局部复发，其中3年内复发者2例。至随访截止，有2例患者死于原发癌，4例死于其他原因，28例生存。术后生存率，3年为97．14％，标准误为0．0358；5年为92．28％。标准误为0．1047。结论 采用适当的手术方式结合放疗可提高头面部皮肤鳞癌的术后生存率。

OPERATIONAL TREATMENT FOR CUTANEOUS SQUAMOUS CANCER OF HEAD AND FACE

Objective To discuss the operative method and experience,through analyzing the medium-term and long-term effect of combined therapy for cutaneous squamous cancer of head and face.Methods From January 1998 to December 2002,37 patients with head or neck cutaneous squamous cancer received combined therapy of operation and radiation.The determination of resect area was based on the stage of the tumor,and according to the resect area and the freedom of peripheral tissue,3 different operation procedures were adopted respectively.The follow-up was ended in June 2004.Results The followup was 5 to 69 months.The median follow-up interval was 38 months.Four patients(10.8%) relapsed during the follow-up,and 2 of them(5.4%) relapsed within 3 years after operation.two patients(5.4%) died from the primary affection,4 patients(10.8%) died from other causes.According to Kaplan-Meier Method,the 3-year survival rate was 97.14% and the standard error was 0.0358,and 5-year survival rate was 92.28% and the standard error was 0.1047.Conclusion The recurrence rate of cutaneous squamous cancer of head and face with a better prognosis is lower than the ones from other origins.And the survival rate may be improved from proper operative method.