Eckel H E
HNO-Abteilung, Klinikum Klagenfurt am Wörthersee, Landeskrankenhaus Klagenfurt, Feschnigstr. 11, 9026, Klagenfurt, Österreich.
HNO. 2012 Jan;60(1):6-18. doi: 10.1007/s00106-011-2422-9.
The prognosis of squamous epithelial cell carcinoma of the upper aerodigestive tract has improved considerably in the last 30 years. Patients presenting with stage I or II disease are treated with surgery or radiation therapy with curative intent. Although the efficacy is comparable between the two methods, surgery is usually preferred so that the side effects and late toxic effects of radiation can be avoided. For the treatment of advanced stages of disease, surgery, radiotherapy, chemotherapy and immunotherapy are usually combined. The introduction of concurrent administration of chemotherapy and radiotherapy (chemoradiotherapy) has been a major advancement. This has resulted in local control and survival rates comparable to those seen following radical surgery and postoperative radiotherapy, but with preservation of the larynx in most patients. However, recent epidemiological observations have shown declining survival rates in laryngeal cancer patients, raising concern about uncritical and too frequent use of this approach. The rationale for choosing treatment options for patients with laryngeal and hypopharyngeal carcinoma is discussed.
在过去30年中，上消化道鳞状上皮细胞癌的预后有了显著改善。患有I期或II期疾病的患者接受以治愈为目的的手术或放射治疗。虽然这两种方法的疗效相当，但通常首选手术，以便避免放疗的副作用和晚期毒性作用。对于晚期疾病的治疗，通常将手术、放疗、化疗和免疫疗法联合使用。同步放化疗的引入是一项重大进展。这使得局部控制率和生存率与根治性手术和术后放疗后的情况相当，但大多数患者的喉部得以保留。然而，最近的流行病学观察表明喉癌患者的生存率在下降，这引发了对这种方法不加区分和过度频繁使用的担忧。本文讨论了喉癌和下咽癌患者治疗方案选择的依据。
