Ahmet KARADENİZ, Mert SAYNAK, Züleyha KADEHCİ, Merdan FAYDA, Görkem AKSU, Hümeyra KOCAELLİ, Günter HAFIZ

Dil kanserinde kombine tedavi cerrahi ve radyoterapi sonuçlar› ve prognostik faktörler

Amaç: Cerrahi ve cerrahi sonrası radyoterapi uygulanan primer dil kanserli hastalarda tedavi sonuçları değerlendirildi ve prognostik faktörler araştırıldı.Hastalar ve Yöntemler: Çalışmaya ameliyat sonrasında radyoterapi uygulanan dil kanserli 60 hasta alındı.Hastaların tümör evresine AJCC-1997 göre dağılımı, evre I n=1 , evre II n=21 , evre III n=12 , evreIVA n=26 şeklindeydi. Cerrahi tedavide 46 hastaya %76 hemiglossektomi, 13 hastaya %22 parsiyel,bir hastaya %2 total glossektomi, 47 hastada %78 boyun diseksiyonu uygulandı. Işın dozu genellikle6000 cGy/30 fr idi. Medyan takip süresi 51 ay dağılım5-180 ay idi.Bulgular: Tedavi sonrası beş yıllık genel ve hastalıksızsağkalım oranları sırasıyla %50 ve %47 idi. Beş yıllıkgenel sağkalım evre I-III’de %70, evre IVA’da %20 bulundu. Yinelemeler çoğunlukla ilk iki yılda görüldü. Toplam 31hastada %52 yineleme görüldü. Yineleme sonrası medyan sağkalım sekiz ay dağılım 1-53 ay idi. Çokdeğişkenli analizde, tümör çapı, evre, N evresi, kapsüler invazyonvarlığı ve toplam radyoterapi süresi yerel-bölgesel kontrolve genel sağkalım için anlamlı prognostik faktörler olarakbelirlendi. Tedaviye bağlı komplikasyonlar kabul edilebilirsınırlar içinde kaldı.Sonuç: Ameliyat sonrası radyoterapi evre III ve IVA dilkanseri olgularında standart olarak uygulanmalıdır

Anahtar Kelimeler:

Skuamöz hücreli karsinom, prognoz, radyoterapi, dil neoplazileri

The results of combined treatment surgery and postoperative radiotherapy for tongue cancer and prognostic factors

Objectives: We evaluated the results of surgical treatment and postoperative radiotherapy and prognostic factors in patients with primary tongue carcinoma. Patients and Methods: The study included 60 patients 31 males, 29 females; median age 54 years; range 22 to 82 years who underwent surgery and postoperative radiotherapy for oral tongue cancer. Tumor staging based on the AJCC-1997 criteria was as follows: stage I n=1 , stage II n=21 , stage III n=12 , and stage IVA n=26 . Surgery included hemiglossectomy n=46, 76% , partial n=13, 22% and total n=1, 2% glossectomy. Neck dissection was performed in 47 patients 78% . Radiotherapy dose was generally 6000 cGy/30 fr. The median follow-up was 51 months range 5 to 180 months . Results: The five-year overall and relapse-free survival rates were 50% and 47%, respectively. Survival at five years was 70% for stage I-III, and 20% for stage IVA. Most of the relapses occurred in the first two years after treatment. Recurrences were encountered in 31 patients 52% . The median survival after recurrence was eight months range 1 to 53 months . In multivariate analyses, significant prognostic factors for overall survival and locoregional control were tumor size, stage, N stage, extracapsular lymph node spread, and total duration of radiotherapy. Complications were within acceptable limits. Conclusion: Postoperative radiotherapy should be standard for patients with stage III and IVA tongue cancer.

Keywords:

Squamous cell carcinoma, prognosis, radiotherapy, tongue neoplasms,

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