经口激光微创手术联合放疗治疗口咽肿瘤：梅奥诊所亚利桑那州的经验。
Transoral laser microsurgery followed by radiation therapy for oropharyngeal tumors: the Mayo Clinic Arizona experience.
机构信息
Department of Radiation Oncology, Mayo Clinic, Scottsdale, Arizona.
出版信息
Head Neck. 2014 Feb;36(2):220-5. doi: 10.1002/hed.23279. Epub 2013 Mar 26.
BACKGROUND
The purpose of this study was to report the treatment outcomes of patients with advanced oropharyngeal cancer treated with transoral laser microsurgery (TLM) followed by radiation therapy (RT) at Mayo Clinic in Arizona.
METHODS
A retrospective study of 80 patients treated from January 1, 2000 to November 7, 2011 was performed. All patients had stage III/IV oropharyngeal tumors and underwent TLM with neck dissection. Adjuvant RT was then given. Thirty-seven patients received concurrent adjuvant chemotherapy. The primary outcome was locoregional control.
RESULTS
Median follow-up was 47.3 months (range, 9.7-139.2 months). The 3-year locoregional control, recurrence-free survival, and overall survival rates were 98.6% (95% confidence interval [CI], 91% to 100%), 91.1% (95% CI, 81% to 96%), and 93.7% (95% CI, 84% to 98%), respectively. There were a total of 5 treatment failures, 1 regional and 4 distant. Twenty-six patients underwent neck only RT with exclusion of the primary site.
CONCLUSION
TLM followed by RT for advanced oropharyngeal cancer results in excellent locoregional control rates.
背景
本研究旨在报告在亚利桑那州梅奥诊所接受经口激光微创手术（TLM）联合放射治疗（RT）治疗的晚期口咽癌患者的治疗结果。
方法
对 2000 年 1 月 1 日至 2011 年 11 月 7 日期间接受治疗的 80 例患者进行回顾性研究。所有患者均为 III/IV 期口咽肿瘤，行 TLM 联合颈部清扫术。然后给予辅助 RT。37 例患者接受了同期辅助化疗。主要结局为局部区域控制。
结果
中位随访时间为 47.3 个月（范围，9.7-139.2 个月）。3 年局部区域控制、无复发生存和总生存率分别为 98.6%（95%置信区间，91%-100%）、91.1%（95%置信区间，81%-96%）和 93.7%（95%置信区间，84%-98%）。共有 5 例治疗失败，1 例为局部区域，4 例为远处转移。26 例患者仅行颈部 RT，不包括原发灶。
结论
TLM 联合 RT 治疗晚期口咽癌可获得优异的局部区域控制率。
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