老年舌鳞状细胞癌的手术治疗及放射治疗疗效分析

目的分析不同治疗方法治疗老年(≥60岁)舌鳞状细胞癌的疗效。方法对1993年3月至2006年5月期间收治的31例老年舌鳞状细胞癌患者进行回顾性分析,比较单纯手术、单纯治疗、术前放疗和术后放疗对舌鳞状细胞癌患者5年生存率和复发率的影响。结果单纯手术组、单纯放疗组、术前放疗组、术后治疗组的Ⅰ^Ⅱ期老年舌鳞状细胞癌患者的5年累积生存率分别为87.5%、73.9%、80.0%和83.3%(P=0.206),复发率分别为31.2%、42.3%、29.3%和26.4%(P=0.132);ⅢⅡ期老年舌鳞状细胞癌患者的5年累积生存率分别为87.5%、73.9%、80.0%和83.3%(P=0.206),复发率分别为31.2%、42.3%、29.3%和26.4%(P=0.132);Ⅲ^Ⅳ期患者的5年累积生存率分别为62.5%、17.4%、60.8%和62.7%(P=0.012),复发率分别为63.8%、92.3%、50.1%和61.3%(P<0.001)。结论老年早期舌鳞状细胞癌患者可采用单纯手术治疗,晚期舌鳞状细胞癌的治疗宜采用手术联合放射治疗。

Curative effect analysis of operation and radiotherapy in elderly patients with tongue squamous cell carcinoma

Objective To analyze the curative effect of different treatment methods in elderly patients＇ oral tongue squamous cell carcinoma. Methods Treatment outcome was retrospectively assessed in 131 elderly patients with oral tongue squamous cell carcinoma who were received treatment in Chongqing Cancer Institute between March 1993 to May 2006. Compared the 5-year survival rate and recurrence rate of pure surgery,pure irradiation,irradiation before surgery and irradiation after surgery. Results The 5-year accumulate survival rate of pure surgery, pure irradiation ,irradiation before surgery and irradiation after surgery in early-stage cancer（TI - Ⅱ） were 87.5% ,73.9% ,80.0% and 83.3% , respectively （P =0. 206）. While the recurrence rate were 31.2% ,42. 3% ,29. 3% and 26.4%, respectively （P = 0. 132）. The 5- year accumulate survival rate of pure surgery ,pure irradiation,irradiation before surgery and irradiation after surgery in stage Ⅲ and Ⅳ were 62. 5% ,17.4% ,60. 8 and 62.7%, respectively （P =0. 012）. While the recurrence rate were 63.8% ,92. 3% ,50. 1% and 61.3%, respectively （P 〈 0. 001 ）. Conclusion Surgery is effective in treating the elderly patients of early squamous cell carcinoma. Radiation therapy combined with surgery is effective in the treatment of elderly patients＇ advanced squamous cell carcinoma.