Nomiya Takuma, Nemoto Kenji, Wada Hitoshi, Takai Yoshihiro, Yamada Shogo
Department of Radiation Oncology, Yamagata University School of Medicine, Yamagata, Japan.
Laryngoscope. 2008 Aug;118(8):1417-21. doi: 10.1097/MLG.0b013e3181781791.
OBJECTIVE/HYPOTHESIS: The purpose of this study is to determine the prognostic factors for local control and significance of total radiation dose in T1 glottic cancer.
Retrospective study.
Data from 163 patients with T1 N0 M0 Stage I glottic squamous cell carcinoma (T1a: 115, T1b: 48) who were treated with radiotherapy alone during 1976 to 2002 were analyzed retrospectively. Age, source, total dose, field size, overall treatment time, and average fraction size were set as variables in multivariate analysis.
The 5-year local control rates (LCR) were 92.3% and 85.0% for patients with T1a and T1b glottic carcinoma, respectively. Only total radiation dose (P = .048) was a significant prognostic factor for local control in multivariate analysis of T1b glottic carcinoma. Local control in the higher total dose group was better than that in the lower total dose group (5 year LCRs were 100% and 76% for the group of > 66 Gy and the group of < or = 66 Gy, respectively. P = .024, logrank test). None of the treatment parameters were shown to be significant prognostic factors in multivariate analysis of T1a glottic carcinoma.
Radiotherapy with a total dose of 67 to 70 Gy seemed to be required for local control in T1b glottic carcinoma. No significant benefit of total radiation dose > 64 Gy was shown in the analysis of T1a glottic carcinoma.
目的/假设：本研究旨在确定T1期声门癌局部控制的预后因素及总辐射剂量的意义。
回顾性研究。
回顾性分析1976年至2002年间仅接受放射治疗的163例T1N0M0Ⅰ期声门鳞状细胞癌患者（T1a：115例，T1b：48例）的数据。将年龄、来源、总剂量、照射野大小、总治疗时间和平均分次剂量作为多因素分析的变量。
T1a期和声门癌患者的5年局部控制率（LCR）分别为92.3%和85.0%。在T1b期声门癌的多因素分析中，仅总辐射剂量（P = 0.048）是局部控制的显著预后因素。总剂量较高组的局部控制优于总剂量较低组（> 66 Gy组和≤ 66 Gy组的5年LCR分别为100%和76%。P = 0.024，对数秩检验）。在T1a期声门癌的多因素分析中，没有治疗参数显示为显著的预后因素。
T1b期声门癌局部控制似乎需要67至70 Gy的总剂量放疗。在T1a期声门癌分析中，未显示总辐射剂量> 64 Gy有显著益处。
