声门型喉鳞状细胞癌 T1N0 至 T2N0，采用根治性放疗治疗。

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

机构信息

Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, USA.

出版信息

Int J Radiat Oncol Biol Phys. 2010 Oct 1;78(2):461-6. doi: 10.1016/j.ijrobp.2009.08.066. Epub 2010 Feb 12.

DOI:10.1016/j.ijrobp.2009.08.066

PMID:20153124

Abstract

PURPOSE

To report the treatment outcomes of definitive radiotherapy (RT) for early-stage squamous cell carcinoma (SCCA) of the glottic larynx.

METHODS AND MATERIALS

We retrospectively reviewed the medical records of 585 patients with T1N0 to T2N0 invasive SCCA of the glottic larynx treated between 1964 and 2006 with RT alone. All patients had at least 2 years of follow-up, had histologic diagnosis of invasive SCCA, and received continuous-course RT. None of these patients received chemotherapy or had elective nodal RT. The probabilities of local control (LC), ultimate LC, ultimate LC with larynx preservation, neck control, cause-specific survival (CSS), and overall survival (OS) were calculated by the Kaplan-Meier product-limit method.

RESULTS

The median follow-up for survivors was 12 years. Five-year LC rates were as follows: T1A, 94%; T1B, 93%; T2A, 80%; and T2B, 70%. Multivariate analysis revealed that overall treatment time greater than 41 days (p = 0.001) and poorly differentiated histology (p = 0.016) adversely affected LC. Five-year rates of ultimate LC with laryngeal preservation were: T1A, 95%; T1B, 94%, T2A, 81%; and T2B, 74%. Twenty-four (4%) of 585 patients failed in the neck; only 7 neck failures (1%) were isolated. Five-year CSS and OS rates were as follows: T1A, 97% and 82%; T1B, 99% and 83%; T2A, 94% and 76%; and T2B, 90% and 78%, respectively. Ten (1.7%) patients had severe and/or fatal complications. One patient died of a radiation-induced carotid artery angiosarcoma.

CONCLUSION

Based on our study results, RT cures a high proportion of patients with T1N0 to T2N0 glottic SCCAs and has a low rate of severe complications.

摘要

目的

报告早期声门型鳞状细胞癌（SCCA）行根治性放疗（RT）的治疗结果。

方法和材料

我们回顾性分析了 1964 年至 2006 年间 585 例 T1N0 至 T2N0 局部浸润性声门型 SCCA 患者的病历资料，所有患者均接受单纯 RT 治疗，且均至少随访 2 年，均经组织学诊断为浸润性 SCCA，且接受了连续疗程的 RT 治疗。这些患者均未接受化疗或选择性颈部淋巴结 RT。采用 Kaplan-Meier 乘积限法计算局部控制率（LC）、最终 LC、最终保喉 LC、颈部控制率、无特定原因生存率（CSS）和总生存率（OS）。

结果

幸存者的中位随访时间为 12 年。5 年 LC 率如下：T1A 为 94%；T1B 为 93%；T2A 为 80%；T2B 为 70%。多因素分析显示，总治疗时间大于 41 天（p=0.001）和低分化组织学（p=0.016）会降低 LC。5 年保喉最终 LC 率分别为：T1A 为 95%；T1B 为 94%，T2A 为 81%；T2B 为 74%。585 例患者中有 24 例（4%）发生颈部失败，仅有 7 例（1%）为孤立性颈部失败。5 年 CSS 和 OS 率分别为：T1A 为 97%和 82%；T1B 为 99%和 83%；T2A 为 94%和 76%；T2B 为 90%和 78%。10 例（1.7%）患者发生严重和/或致命并发症。1 例患者死于放射诱导的颈动脉血管肉瘤。