Fox Chase Cancer Center, (American College of Surgeons), Philadelphia, Pennsylvania.
Head Neck. 2014 Jan;36(1):3-8. doi: 10.1002/hed.23381. Epub 2013 Sep 18.
Controversy surrounds the appropriate therapy for T1 glottic cancer. Both transoral endolaryngeal resection and radiation offer excellent local control and voice quality; some lesions are best addressed with resection and others with radiation.
The American College of Radiology (ACR) Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed by a multidisciplinary expert panel. The guideline development includes an analysis of current literature from peer reviewed journals and the well-established "modified Delphi" consensus methodology to rate the appropriateness of treatment. Where evidence is not definitive, expert opinion informed recommendations.
The ACR Expert Panel on Radiation Oncology - Head and Neck Cancer developed consensus recommendations for treatment of T1 glottic cancer. Treatment planning is complex and decisions nuanced.
Best treatment for a particular cancer cannot be defined without consideration of the lesion's location, extent, depth of invasion, and quality of surgical exposure during direct laryngoscopy.
对于 T1 声门型喉癌，争议集中于适当的治疗方法。经口内镜下喉切除术和放射治疗均可提供良好的局部控制和嗓音质量；有些病变最适合采用切除术，而另一些则适合采用放射治疗。
美国放射学院（ACR）适宜性标准是针对特定临床情况的循证指南，由多学科专家小组进行审查。指南制定包括对同行评议期刊的现有文献进行分析，以及经过充分验证的“改良 Delphi”共识方法，以评估治疗的适宜性。在证据不明确的情况下，专家意见指导建议。
美国放射学院头颈部肿瘤放射治疗专家小组就 T1 声门型喉癌的治疗达成了共识建议。治疗计划复杂，决策需要权衡。
如果不考虑直接喉镜检查时病变的位置、范围、浸润深度以及手术暴露的质量，就无法确定特定癌症的最佳治疗方法。
