经口激光显微手术治疗放射性复发性喉癌的肿瘤学结果：英语文献的系统评价和荟萃分析。
Oncologic outcomes of transoral laser microsurgery for radiorecurrent laryngeal carcinoma: a systematic review and meta-analysis of English-language literature.
机构信息
Department of Otolaryngology- Head and Neck Surgery, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom; Department of Otolaryngology- Head and Neck Surgery, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom.
出版信息
Head Neck. 2014 Feb;36(2):280-5. doi: 10.1002/hed.23291. Epub 2013 Jun 14.
BACKGROUND
The purpose of this systematic review and meta-analysis was to assess the oncological and functional outcomes of transoral laser microsurgery (TLM) in radiorecurrent laryngeal cancer.
METHODS
The review was performed using search strategies including Medline, Embase, Zetoc, conference proceedings, and a manual search. Pooled estimates of local control at 24 months, disease-free survival (DFS), and overall survival (OS) rates were calculated.
RESULTS
The pooled mean estimates were: local control rate at 24 months after first TLM (n = 249), 56.9% (95% confidence interval [CI], 47.4-66.1); local control after repeat TLM (n = 186), 63.8% (95% CI, 57.1-70.2); DFS (n = 174), 70.9% (95% CI, 60.8-80); and OS (n = 276), 74.8% (95% CI, 68.2-80.9). Pooled mean laryngeal preservation (n = 286) was 72.3% (95% CI, 68.4-76.1).
CONCLUSION
TLM is oncologically sound in the salvage setting with high larynx-preservation rate, but there is a trend toward inferior local control rates compared to open partial laryngectomy techniques.
背景
本系统评价和荟萃分析的目的是评估经口激光显微手术（TLM）在放射性复发性喉癌中的肿瘤学和功能结局。
方法
使用包括 Medline、Embase、Zetoc、会议记录和手动搜索在内的搜索策略进行了综述。计算了 24 个月局部控制率、无病生存率（DFS）和总生存率（OS）的汇总估计值。
结果
汇总的平均估计值为：首次 TLM 后 24 个月的局部控制率（n = 249），56.9%（95%置信区间 [CI]，47.4-66.1）；重复 TLM 后的局部控制率（n = 186），63.8%（95% CI，57.1-70.2）；DFS（n = 174），70.9%（95% CI，60.8-80）；OS（n = 276），74.8%（95% CI，68.2-80.9）。汇总的平均喉保留率（n = 286）为 72.3%（95% CI，68.4-76.1）。
结论
TLM 在挽救性治疗中具有良好的肿瘤学效果，喉保留率高，但与开放式部分喉切除术技术相比，局部控制率有下降趋势。
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