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基于根治性放疗的下咽癌治疗:谁适合保留喉功能?

Hypopharyngeal cancer treatment based on definitive radiotherapy: who is suitable for laryngeal preservation?

作者信息

Chen S-W, Tsai M-H, Yang S-N, Liang J-A, Shiau A-C, Lin F-J

机构信息

Department of Radiation Therapy, School of Medicine, China Medical University, Taichung, Taiwan.

出版信息

J Laryngol Otol. 2008 May;122(5):506-12. doi: 10.1017/S0022215107000692. Epub 2007 Oct 12.

Abstract

AIMS

To investigate prognostic factors for survival and locoregional control in patients with stage I-IVA hypopharyngeal cancer treated with laryngeal preservation radiotherapy.

METHODS

This study was a retrospective analysis of 108 patients with stage I-IVA squamous cell carcinoma of the hypopharynx, treated with laryngeal preservation radiotherapy. Actuarial survival, disease-specific survival and local relapse-free survival were calculated, and multivariate analyses were performed using Cox's proportional hazards model.

RESULTS

After a median follow-up duration of 39 months, the five-year local relapse-free survival rate was 35 per cent for all patients, 66 per cent for those with stage I-II disease, 46 per cent for those with stage III disease and 20 per cent for those with stage IVA disease (p = 0.004). Multivariate analyses showed that tumour and node stages were independent prognostic factors.

CONCLUSIONS

Patients with stage I-II disease were suitable for laryngeal preservation radiotherapy. For most patients with stage III-IVA disease, other than those who were T1 N1 or T2 N1, the treatment results were poor.

摘要

目的

探讨接受喉保留放疗的I-IVA期下咽癌患者生存及局部区域控制的预后因素。

方法

本研究对108例接受喉保留放疗的I-IVA期下咽鳞状细胞癌患者进行回顾性分析。计算精算生存率、疾病特异性生存率和局部无复发生存率,并使用Cox比例风险模型进行多因素分析。

结果

中位随访39个月后,所有患者的五年局部无复发生存率为35%,I-II期患者为66%,III期患者为46%,IVA期患者为20%(p = 0.004)。多因素分析显示肿瘤和淋巴结分期是独立的预后因素。

结论

I-II期患者适合喉保留放疗。对于大多数III-IVA期患者,除T1 N1或T2 N1患者外,治疗效果较差。

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