| Co-Investigator(Kenkyū-buntansha) |
YOKOE Yoshihiko Kyoto University, Faculty of Medicine, Assistant Professor, 医学研究科, 助手 (30211650)
MURAKAMI Ken-ichiro Kyoto University, Faculty of Medicine, Assosiate Professor, 医学研究科, 助教授 (00174269)
HIRAOKA Masahiro Kyoto University, Faculty of Medicine, Professor, 医学研究科, 教授 (70173218)
YASUDA Shinya Kyoto University, Faculty of Medicine, Assistant Professor, 医学研究科, 助手 (50263075)
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| Research Abstract |
Study for sensitivity to combination therapy of hyperthermia-radiotherapy+immunochemotherary in oral carcinomas was performed. In the clinical application, the combination therapy of preoperative radiation and surgery was actively used, and hyperthermia, immunotherapy and chemotherapy is appeared aduvant means. When the tumor is spreadding to important anatomocal component at the skull base or metastatic lymph nodes such as N3 is invading the common carotid artery, we planned preoperative therapy such as radiation of fifty Gray combined with daily administration of low dose Cisplatin and 5-FU, and occasionally with low dose peplomycin, and furthermore, hyperthermia delivered one time weekly. This preoperative treatment was remarkably effective and surgical resection of tumor was successfully possible with the minimum surgical margin. We have often experienced that those remarkably advanced disease become resactable by aggresive multidisciplinary therapy. Thus, we must try active surgery whenever possible offers a reasonable chance of cure, even if in the so-called inoperative cases or terminal stage cases. Our treatment strategy for oral cancer is explained. For the early lesions (T1, earlyT2), our first choice is adequate excision, because there is a postoperative minimal disability and deformity. For locally advanced cancers (T3, T4), combination therapy with preoperative radiation and minimum invasive surgery is good indicated. Clinico-statistical study on oral cancer in our derpartment for past seven years was performed. Treatment outcome from our cancer series (178 patients, 1990-1997) showed a 5-year survival rate : i. e. Stage1 93% ; Stage2 86% ; Stage3 85% ; StageT4 70% ; and overall rate was 82%. In this study, treatment modality without surgery such as combination therapy of radiotherapy and chemotherapy have cured about 20% of patients with advanced oral squomous cell carcinoma.
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