Comprehensive treatment of tongue cancer, tongue cancer is the highest incidence of oral cancer in the malignant tumor, accounting for the 1/3—1/2 oral cancer, tongue cancer, which accounts for 2 / 3, base of tongue cancer accounts for 1 / 30 pathological type of squamous cell carcinoma accounts for about 90%, a small number of lymphoid cell carcinoma, lymphosarcoma, and adenoid cystic carcinoma. Comprehensive treatment of tongue cancer treated primarily with surgery combined with radiation therapy
1. Surgical treatment
Surgical treatment of the first effect is the key to success. Treatment failure is mainly due to local recurrence and distant metastasis. Lymph node metastasis in early tongue easily, regardless of whether the general idea that cervical lymph node metastases, can be row tongue, collar, combined radical neck surgery, and strive to achieve a negative surgical margin. For T1, 2 No cases or cases of selective neck dissection can be used, selected functional neck surgical removal; T3-4 cases, and Nl-3 cases should be adopted radical neck dissection.
Comprehensive treatment of tongue cancer, 2. Radiotherapy
The effect of radiotherapy is not satisfactory, 5-year survival rate of only 11.1 %—- 37%.
(1) preoperative external irradiation of 60 drill or 4 —- 6MeV accelerator on both sides of the cheek to wear radiation field, radiation field size is generally (9 —- 11) cmX (7 —- 9) cm, hard shoulder to avoid the upper bound, lower bound approach is based on the decision of cervical lymph node. Tumor absorbed dose 45 —- 53y, 4. 5 —- 5 weeks to complete, and then rest 3 —- 4 weeks further surgery. Preoperative irradiation for bulky tongue base of tongue squamous cell carcinoma or undifferentiated carcinoma, which is used to shrink tumors and improve the resection rate.
(2) interstitial radiation interstitial radiation of traditional organizations are anchored needle therapy, has been installed after the mountain by interstitial therapy instead. Interstitial afterloading therapy only solves the problem of protection of medical personnel, while the use of a computer calculation of sources around the contour, the target dose can be clearly demonstrated that radiation therapy planning can be guaranteed.
(3) use of oral conventional simple X-irradiation on the accelerator, or an additional reduction for different mouth shapes the electron beam irradiation. For patients with tumor invasion depth of <0.5cm patients. Irradiation program for each 3Gy, a total of 8 —- 10.
Comprehensive treatment of tongue cancer, (4) after exposure to radiation after the purpose is to eliminate the residual foci invisible. Absorbed radiation dose to tumor volume 45 .-..- 5OGy, 4.5 '- "-5 weeks to complete.