放疗对喉癌生存的影响：基于人群的 13808 例美国患者研究。

Impact of radiotherapy on laryngeal cancer survival: a population-based study of 13,808 US patients.

机构信息

Department of Radiation Oncology, University of Rochester Medical Center, Rochester, New York 14642-8647, USA.

出版信息

Cancer. 2012 Mar 1;118(5):1276-87. doi: 10.1002/cncr.26357. Epub 2011 Jul 19.

DOI:10.1002/cncr.26357

PMID:21773970

Abstract

BACKGROUND

Radiotherapy with its advantage of organ preservation has been used to treat laryngeal cancer (LC) for several decades. However, the impact of radiation on overall survival (OS) in a large population-based study has not been evaluated to date.

METHODS

The authors analyzed all patients who had localized and/or regional glottic and supraglottic cancer in the Surveillance, Epidemiology, and End Results Program by comparing treatment trends and OS for the periods 1988 to 1993, 1994 to 1999, and 2000 to 2006. Kaplan-Meier and logistic regression analyses were conducted to evaluate OS and the influence of patient demographics on treatment received.

RESULTS

Among 13,808 patients with LC, radiotherapy use increased over the 3 periods for localized glottic cancer (LGC) (94%, 97%, and 98% during 1988-1993, 1994-1999, and 2000-2006, respectively; P < .001); for regional glottic cancer (RGC) (53%, 66%, and 75%, respectively; P < .001), for localized supraglottic cancer (LSGC) (61%, 83%, and 94%, respectively), and for regional supraglottic cancer (RSGC) (43%, 55%, and 78%, respectively; P < .001). No significant decrease in 5-year OS was observed during the 3 periods (LGC: 73%, 76%, and 78%, respectively; RGC: 57%, 51%, and 56%, respectively; LSGC: 33%, 35%, and 39%, respectively; and RSGC: 36%, 36%, and 43%, respectively). Blacks were significantly less likely to receive radiotherapy than whites (odds ratio: LGC, 0.42; RGC, 0.76; RSGC, 0.68; all P < .05). Those in the lowest tertile of median household income, compared with highest tertile, received radiotherapy less frequently (odds ratio: LGC, 0.42; RGC, 0.57; RSGC, 0.57; all P < .001).

CONCLUSIONS

The current results indicated that the increased use of radiation with its advantage of speech preservation had no adverse impact on the survival of patients with LC. Black race and low income status had significant, inverse relations with the receipt of radiotherapy.

摘要

背景

放射治疗以其保留器官的优势，已被用于治疗喉癌（LC）数十年。然而，迄今为止，尚未在基于人群的大型研究中评估放射治疗对总生存（OS）的影响。

方法

作者通过比较 1988 年至 1993 年、1994 年至 1999 年和 2000 年至 2006 年期间的治疗趋势和 OS，分析了监测、流行病学和最终结果计划中所有患有局部和/或区域声门和喉上部癌症的患者。进行 Kaplan-Meier 和逻辑回归分析以评估 OS 以及患者人口统计学特征对治疗的影响。

结果

在 13808 例 LC 患者中，放射治疗的使用在 3 个时期内增加，对于局部声门癌（LGC）（分别为 94%、97%和 98%）；对于区域声门癌（RGC）（分别为 53%、66%和 75%）；对于局部喉上部癌（LSGC）（分别为 61%、83%和 94%）和区域喉上部癌（RSGC）（分别为 43%、55%和 78%）；P <.001）。在 3 个时期内，5 年 OS 无显著下降（LGC：分别为 73%、76%和 78%；RGC：分别为 57%、51%和 56%；LSGC：分别为 33%、35%和 39%；RSGC：分别为 36%、36%和 43%）。与白人相比，黑人接受放射治疗的可能性显著降低（优势比：LGC，0.42；RGC，0.76；RSGC，0.68；均 P <.05）。与最高三分位相比，处于中位数家庭收入最低三分位的患者接受放射治疗的频率较低（优势比：LGC，0.42；RGC，0.57；RSGC，0.57；均 P <.001）。