Garcia-Serra Allie, Hinerman Russell W, Amdur Robert J, Morris Christopher G, Mendenhall William M
Department of Radiation Oncology, University of Florida College of Medicine, PO Box 100385, Gainesville, Florida 32610-0385, USA.
Head Neck. 2002 Apr;24(4):390-4. doi: 10.1002/hed.10071.
To report long-term rates of tumor control after radiotherapy (RT) for carcinoma in situ (CIS) of the true vocal cords (TVC). A comprehensive literature review was performed, and outcomes with other modalities of treatment for CIS of the TVC were compared.
Thirty patients with CIS of the TVC were treated between July 1967 and May 1998 with curative intent using megavoltage RT. Most patients (28 of 30) were treated with cobalt-60 through small (usually 5 x 5 cm) fields. Median RT dose was 56.25 Gy (range, 56.25-75 Gy; mean dose, 59.15 Gy) at 2.25 Gy per fraction. One patient was treated for a synchronous head and neck primary malignancy with large fields to a total dose of 75 Gy at 1.8 Gy per fraction. Approximately two thirds of the patients (19 of 30) were referred for RT because of recurrence after at least one stripping procedure.
With a mean follow-up of 7.1 years (range, 2-17 years), the 5-year rates of local control, local control with larynx preservation, and ultimate local control (including salvage surgery) were the following: 88%, 88%, and 100%, respectively. Invasive squamous cell carcinoma developed in three (10%) of the patients. Time to failure was 14 months, 34 months, and 48 months, respectively. All three patients were surgically salvaged with a total laryngectomy. Cause-specific survival at 5 years was 100%. There were no late complications.
RT to approximately 60 Gy at 2.25 Gy per fraction using small (5 x 5 cm) fields produces excellent results with CIS of the TVC.
报告真声带原位癌（CIS）放疗（RT）后的长期肿瘤控制率。进行了全面的文献综述，并比较了真声带原位癌其他治疗方式的结果。
1967年7月至1998年5月，30例真声带原位癌患者接受了根治性兆伏放疗。大多数患者（30例中的28例）通过小（通常为5×5 cm）野接受钴-60治疗。中位放疗剂量为56.25 Gy（范围56.25 - 75 Gy；平均剂量59.15 Gy），每次分割剂量为2.25 Gy。1例患者因同步发生的头颈部原发性恶性肿瘤接受大野放疗，总剂量75 Gy，每次分割剂量1.8 Gy。约三分之二的患者（30例中的19例）因至少一次剥脱手术后复发而接受放疗。
平均随访7.1年（范围2 - 17年），5年局部控制率、保喉局部控制率和最终局部控制率（包括挽救性手术）分别如下：88%、88%和100%。3例（10%）患者发生侵袭性鳞状细胞癌。失败时间分别为14个月、34个月和48个月。所有3例患者均通过全喉切除术挽救。5年病因特异性生存率为100%。无晚期并发症。
使用小（5×5 cm）野，每次分割剂量2.25 Gy，放疗至约60 Gy，对真声带原位癌可产生优异结果。
