Fedok F G, Strauss M, Stryker J
Division of Otolaryngology Head and Neck Surgery, Milton S. Hershey Medical Center, Pennsylvania State University, Hershey 17033.
Trans Pa Acad Ophthalmol Otolaryngol. 1990;42:1061-7.
This study is a retrospective review between 1976 and 1986 of 12 patients with T1(1) and T2(11) NO supraglottic cancers which were managed by a method that utilized planned preoperative radiotherapy (45-51 Gy) to the primary and bilateral necks. If adequate tumor response (greater than 75% reduction in size) was noted by laryngoscopy, therapy was completed at levels of 65-70 Gy to the primary. If a lesser tumor response was noted, the patient underwent supraglottic laryngectomy. Six patients completed primary radiotherapy (RT-RT) and six patients underwent supraglottic laryngectomy (RT-SG). There was evidence of residual tumor in three of six RT-SG patients. No tumor recurred at any site. Laryngeal function was preserved in all patients. Absolute survival was 58% at 67 months. This approach is oncologically sound and permits maximal laryngeal conservation.
本研究是对1976年至1986年间12例T1(1)和T2(11)期声门上型NO癌患者的回顾性分析，这些患者采用的治疗方法是对原发灶和双侧颈部进行术前计划性放疗（45 - 51 Gy）。如果喉镜检查显示肿瘤有足够的反应（肿瘤大小缩小超过75%），则对原发灶追加放疗至65 - 70 Gy以完成治疗。如果肿瘤反应较小，患者则接受声门上喉切除术。6例患者完成了单纯放疗（RT - RT），6例患者接受了声门上喉切除术（RT - SG）。6例接受RT - SG的患者中有3例有残留肿瘤证据。任何部位均未出现肿瘤复发。所有患者的喉功能均得以保留。67个月时的绝对生存率为58%。这种方法在肿瘤学上是合理的，并且能够最大程度地保留喉部。
