Hamby L, McGrath P C, Luce E A, Meeker W, Kenady D E
Division of General Surgery, University of Kentucky College of Medicine, Lexington.
Am J Surg. 1992 Dec;164(6):629-33. doi: 10.1016/s0002-9610(05)80722-6.
Advocates of chemotherapy plus radiation as the definitive treatment for patients with advanced laryngeal cancer often cite older studies that attribute cure rates of less than 50% to laryngectomy plus radiation. The outcomes of patients with stage III and IV laryngeal and pyriform sinus carcinoma from 1980 to 1989 (96 patients) were compared with those of patients treated from 1962 to 1977 (84 patients). Demographics, the extent of disease, and nodal involvement were similar between the groups. There were more operative complications (45% versus 22%; p < 0.01) and deaths (10% versus 2%; p < 0.01) in the patients who underwent irradiation preoperatively. Overall survival was improved in the recent group compared with the early group (73% versus 54% at 5 years; p < 0.03), as was disease-free survival (64% versus 38% at 5 years; p < 0.02). Results of treatment for advanced laryngeal and pyriform sinus carcinoma have improved significantly. These modern results should be used to evaluate newer treatment modalities.
对于晚期喉癌患者，主张采用化疗加放疗作为根治性治疗方法的人常常引用一些较早的研究，这些研究认为喉切除术加放疗的治愈率低于50%。将1980年至1989年期间（96例患者）III期和IV期喉癌及梨状窝癌患者的治疗结果与1962年至1977年期间（84例患者）接受治疗的患者的结果进行了比较。两组患者的人口统计学特征、疾病范围和淋巴结受累情况相似。术前接受放疗的患者手术并发症更多（45%对22%；p<0.01），死亡人数也更多（10%对2%；p<0.01）。与早期组相比，近期组的总生存率有所提高（5年时分别为73%和54%；p<0.03），无病生存率也是如此（5年时分别为64%和38%；p<0.02）。晚期喉癌和梨状窝癌的治疗结果有了显著改善。这些现代结果应用于评估更新的治疗方式。
