Kogashiwa Yasunao, Yamauchi Kohichi, Nagafuji Hiroshi, Matsuda Takehiro, Tsubosaka Toshihito, Tsutsumi Tomoko, Karaho Takehiro, Kohno Naoyuki
Department of Otolaryngology, Head and Neck Surgery, Kyorin University School of Medicine, Tokyo 181-8611, Japan.
Oncol Rep. 2009 Nov;22(5):1163-7. doi: 10.3892/or_00000550.
Preservation of the larynx is the most critical factor influencing quality of life in the treatment of head and neck cancer. This clinical study focuses on laryngeal function-preserving chemoradiotherapy for locally advanced hypopharyngeal and laryngeal cancer. Thirty-two resectable cases with histologically proven squamous cell carcinoma undergoing function-preserving therapy were examined. Induction chemotherapy comprised cisplatin and 5-fluorouracil, and another cycle of chemotherapy was performed for responders. Chemoradiotherapy comprised conventional irradiation and weekly chemotherapy (nedaplatin plus docetaxel). Non-responder patients were excluded from further chemotherapy and were changed to other surgical treatment. Three patients were non-responders for induction chemotherapy, and 29 patients were treated with chemoradiotherapy. Thus, 21 out of 29 patients obtained preserved laryngeal function. Initial larynx preservation rate with these treatment strategies was 93.8%. This study provides a new concept for laryngeal function-preserving treatment that should be considered for locally advanced laryngeal and hypopharyngeal cancer.
保留喉功能是影响头颈癌治疗后生活质量的最关键因素。这项临床研究聚焦于局部晚期下咽癌和喉癌的保留喉功能放化疗。对32例经组织学证实为鳞状细胞癌且接受保留功能治疗的可切除病例进行了检查。诱导化疗采用顺铂和5-氟尿嘧啶，对有反应者进行了另一周期的化疗。放化疗包括常规放疗和每周化疗（奈达铂加多西他赛）。无反应患者被排除在进一步化疗之外，并改为其他手术治疗。3例患者诱导化疗无反应，29例患者接受了放化疗。因此，29例患者中有21例获得了保留的喉功能。这些治疗策略的初始喉保留率为93.8%。本研究为局部晚期喉癌和下咽癌的保留喉功能治疗提供了一个应予以考虑的新概念。
