Department of Otolaryngology-Head and Neck Surgery Washington University School of Medicine, St. Louis, Missouri, USA.
Head Neck. 2011 Dec;33(12):1683-94. doi: 10.1002/hed.21669. Epub 2011 Jan 31.
Nonsurgical modalities are sometimes advocated as the standard of care for advanced oropharyngeal tumors. Oncologic and functional results have been modest. The aim of our study was to evaluate outcomes of a minimally invasive approach, using transoral laser microsurgery (TLM) as the primary treatment for advanced oropharyngeal carcinoma.
A prospectively assembled database of 204 patients with American Joint Committee on Cancer (AJCC) stages III and IV tonsil or tongue base cancer, treated primarily with TLM during 1996-2006 at 3 centers with minimum 2-year follow-up was analyzed. Survival, locoregional control, and swallowing status were recorded.
Mean follow-up was 49 months and 79.4% of patients were alive. Three-year overall survival, disease-specific survival, and disease-free survival were 86%, 88%, and 82%, respectively. Local control was 97%, and 87% of patients had normal swallowing or episodic dysphagia.
TLM as a primary treatment for advanced oropharyngeal malignancy confers excellent survival and swallowing proficiency.
非手术治疗方法有时被提倡作为晚期口咽肿瘤的标准治疗方法。但肿瘤学和功能结果并不理想。我们的研究目的是评估采用经口激光微创手术（TLM）作为晚期口咽癌主要治疗方法的微创方法的结果。
前瞻性地汇总了 204 例美国癌症联合委员会（AJCC）分期为 III 期和 IV 期的扁桃体或舌根癌患者数据库，这些患者在 1996 年至 2006 年期间在 3 个中心接受 TLM 治疗，随访时间至少为 2 年。记录了生存率、局部区域控制率和吞咽状况。
平均随访时间为 49 个月，79.4%的患者存活。3 年总生存率、疾病特异性生存率和无病生存率分别为 86%、88%和 82%。局部控制率为 97%，87%的患者吞咽正常或偶尔出现吞咽困难。
TLM 作为晚期口咽恶性肿瘤的主要治疗方法可获得良好的生存率和吞咽功能。
