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在一家私人诊所进行 T1-T2 声门型癌症的放射治疗。

Radiation therapy for management of t1-t2 glottic cancer at a private practice.

机构信息

Department of Radiation Oncology, Phoebe Putney Memorial Hospital, Albany, Georgia, USA.

出版信息

Am J Clin Oncol. 2010 Dec;33(6):587-90. doi: 10.1097/COC.0b013e3181beaab0.


DOI:10.1097/COC.0b013e3181beaab0
PMID:20051812
Abstract

PURPOSE: The purpose of this study was to retrospectively analyze patients with T1-T2N0 squamous cell carcinomas of the glottic larynx treated at a private institution, to review the pertinent literature, and to compare our outcomes to those of academic institutions. METHODS AND MATERIALS: A total of 118 patients were treated with radiation therapy between May 1987 and August 2006 at a private institution and followed up for ≥2 years. Three patients were lost to follow-up between 18 and 19 months. RESULTS: The 5-year local control rates were: T1a, 91%; T1b, 95%; T2a, 96%; and T2b, 100%. The 5-year ultimate local control rates after irradiation and including patients who were successfully salvaged with surgery after a local recurrence were: T1a, 94%; T1b, 100%; T2a, 96%; and T2b, 100%. Eight (7%) of the 118 patients developed a local recurrence. There were no isolated regional or distant recurrences. The 5-year overall survival rates were: T1a, 73%; T1b, 78%; T2a, 62%; and T2b, 69%. The 5-year cause-specific survival rates were: T1a, 96%; T1b, 100%; T2a, 100%; and T2b, 100%. Two patients experienced severe complications. CONCLUSION: Patients with limited T1aN0 cancers may be treated with either transoral laser excision or RT. Those with more advanced T1-T2N0 cancers are treated with definitive RT. We do not advocate elective nodal irradiation, even for those with bulky T2B malignancies. The addition of concomitant weekly cisplatin 30 mg/M² is considered for patients with T2B cancers. Open parotid laryngectomy is reserved for salvage of suitable patients with a local recurrence.

摘要

目的:本研究旨在回顾性分析在私立机构治疗的 T1-T2N0 声门型鳞状细胞癌患者,回顾相关文献,并将我们的结果与学术机构进行比较。

方法和材料:1987 年 5 月至 2006 年 8 月期间,在一家私立机构共治疗了 118 例接受放疗的患者,并随访至少 2 年。有 3 例患者在 18 至 19 个月时失访。

结果:5 年局部控制率分别为:T1a 为 91%;T1b 为 95%;T2a 为 96%;T2b 为 100%。包括局部复发后成功手术挽救的患者在内,经放疗后 5 年的最终局部控制率分别为:T1a 为 94%;T1b 为 100%;T2a 为 96%;T2b 为 100%。118 例患者中有 8 例(7%)发生局部复发。无孤立的区域或远处复发。5 年总生存率分别为:T1a 为 73%;T1b 为 78%;T2a 为 62%;T2b 为 69%。5 年特异性生存率分别为:T1a 为 96%;T1b 为 100%;T2a 为 100%;T2b 为 100%。有 2 例患者发生严重并发症。

结论:对于局限于 T1aN0 的癌症患者,可采用经口激光切除或放疗进行治疗。对于更晚期的 T1-T2N0 癌症患者,采用根治性放疗。我们不主张选择性淋巴结照射,即使对于体积较大的 T2B 恶性肿瘤也是如此。对于 T2B 癌症患者,考虑加用顺铂(每周 30mg/M²)同期治疗。对于有局部复发的合适患者,保留开放式腮腺切除术作为挽救手段。

相似文献

[1]
Radiation therapy for management of t1-t2 glottic cancer at a private practice.

Am J Clin Oncol. 2010-12

[2]
Decreased local control following radiation therapy alone in early-stage glottic carcinoma with anterior commissure extension.

Strahlenther Onkol. 2004-2

[3]
T1N0 to T2N0 squamous cell carcinoma of the glottic larynx treated with definitive radiotherapy.

Int J Radiat Oncol Biol Phys. 2010-2-12

[4]
Intensity-modulated radiotherapy for locally advanced cancers of the larynx and hypopharynx.

Head Neck. 2011-1

[5]
Impact and management of airway obstruction in patients with squamous cell carcinoma of the larynx.

Head Neck. 2011-1

[6]
Significance of pretreatment hemoglobin level in patients with T1 glottic cancer.

Radiat Oncol Investig. 1999

[7]
Salvage surgery after radiotherapy failure in T1-T2 squamous cell carcinoma of the glottic larynx.

Head Neck. 1996

[8]
Higher laryngeal preservation rate after CO2 laser surgery compared with radiotherapy in T1a glottic laryngeal carcinoma.

Head Neck. 2009-6

[9]
[Radiotherapy in glottic T1 carcinoma. Local control and survival].

Acta Otorrinolaringol Esp. 2000

[10]
Long-term results of radiotherapy for T1a and T1bN0M0 glottic carcinoma.

Laryngoscope. 2008-8

引用本文的文献

[1]
Dysphagia in Open Partial Horizontal Laryngectomy Type IIa: Quantitative Analysis of Videofluoroscopy using the ASPEKT Method.

Dysphagia. 2024-10

[2]
Organ preservation and oncological outcomes in early laryngeal cancer: a propensity score-based study.

Acta Otorhinolaryngol Ital. 2021-8

[3]
Prognostic factors of patients with initially diagnosed T1a glottic cancer: Novel nomograms and a propensity-score matched cohort analysis.

Medicine (Baltimore). 2020-11-6

[4]
Survival results of 3786 patients with stage I or II laryngeal squamous cell carcinoma: a study based on a propensity score.

Braz J Otorhinolaryngol. 2022

[5]
Survival and Prognostic Factors for Outcome after Radiotherapy for T2 Glottic Carcinoma.

Cancers (Basel). 2019-9-6

[6]
Involvement of the Anterior Commissure in Early Glottic Cancer (Tis-T2): A Review of the Literature.

Cancers (Basel). 2019-8-23

[7]
Outcomes of carotid-sparing IMRT for T1 glottic cancer: Comparison with conventional radiation.

Laryngoscope. 2019-2-12

[8]
Radiotherapy for T3N0 glottic carcinoma without cord fixation: elective nodal irradiation or not?

Oncotarget. 2017-7-18

[9]
Radiological tumor thickness as a risk factor for local recurrence in early glottic cancer treated with laser cordectomy.

Eur Arch Otorhinolaryngol. 2018-1

[10]
Therapeutic modalities and oncologic outcomes in the treatment of T1b glottic squamous cell carcinoma: a systematic review.

Eur Arch Otorhinolaryngol. 2017-12

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