Department of Radiation Oncology, Phoebe Putney Memorial Hospital, Albany, Georgia, USA.
Am J Clin Oncol. 2010 Dec;33(6):587-90. doi: 10.1097/COC.0b013e3181beaab0.
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.
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。
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