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上呼吸、消化道恶性肿瘤多是鳞癌。对Ⅰ、Ⅱ期病人或手术或放疗效果都不错,但对Ⅲ、Ⅳ期病人单纯放疗或单纯手术疗效均不满意,失败原因主要是原发灶或颈淋巴结转移灶残留或复发,仅因远处转移的只占少数。手术可切除大块肿瘤,但不能切除切缘以外的潜在病灶;而放疗能消灭亚临床灶,但不能根治大块肿瘤。两者联合应用则可互相取长补短。原发灶复发是手术治疗头颈部癌失败的主要原因之一。Losser报告Ⅲ、Ⅳ期病人单纯手术切除,边缘切净者局部复发率是45%;手术切缘小于0.5cm或切缘病理切片有肿瘤者可高达75%。
Upper respiratory and gastrointestinal cancers are mostly squamous cell carcinomas. The results of stage I and II patients or surgery or radiotherapy are good, but the efficacy of radiotherapy or surgery alone in patients with stage III and IV are not satisfied. The main cause of failure is residual or recurrence of primary tumor or cervical lymph node metastasis, only due to far Only a few are transferred. Surgery can remove large tumors but cannot remove the underlying lesion beyond the margin; radiotherapy can destroy subclinical lesions, but it cannot cure large tumors. The joint application of the two can complement each other. Recurrence of the primary lesion is one of the main reasons for the failure of surgical treatment of head and neck cancer. Losser reported that patients with stage III and IV were treated with surgery. The local recurrence rate of the marginal excision was 45%; the surgical margin was less than 0.5 cm or the pathological section of the resection margin was as high as 75%.