〔第70回日耳鼻総会シンポジウム: 頭頸部悪性腫瘍における三者合併療法〕舌癌治療法の適示と今後の課題

抄録

The forty untreated cases of cancer of the tongue in Aichi Cancer Center Hospital are presented, and the outline of these cases concerning the combined therapy and its indication is discussed.
The clinical factors influencing on prognosis of patients with cancer of the tongue are the size as well as the spread of the primary tumor and the presence of cervical metastasis.By pathomorphological observation it -is turned out that the mononuclear round cell infiltration such as lymphocytes and plasma cells against tumor growth plays an important role during the course of the spread of the primary tumors.
The choice of treatment is irradiation for primary lesion, and is radical neck dissection for cervical lymphadenopathy.
Interstitial radium therapy is still essential to early primary lesion, particulary to that of the cases of T1. In the cases of T2, external irradiation is a suitable treatment and the residual tumors can be followed by small source irradiation.
Futhermore a prophylactic neck dissection should be also performed after irradiation. In the advanced cases such as T3 and T4, the simultaneous irradiation including both the primary and cervical metastatic lesions should be considered as a first therapeutic plan and then radical neck dissection should be carried out as fast as possible. If the primary tumor still remains after irradiation, the combined operation is necessary to the primary and metastatic lesion.
It is stressed that the combination of irradiation with the surgery of infusion chemotherapy is important.