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原发性根治性治疗后复发性下咽癌的挽救治疗。

Salvage of recurrent hypopharyngeal carcinoma after primary curative treatment.

作者信息

Yasumatsu Ryuji, Nakashima Torahiko, Toh Satoshi, Taura Masahiko, Komune Shizuo

机构信息

Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University , Fukuoka , Japan.

出版信息

Acta Otolaryngol. 2013 Oct;133(10):1110-6. doi: 10.3109/00016489.2013.815365. Epub 2013 Aug 7.

Abstract

CONCLUSIONS

There was a moderate chance of cure after surgical salvage of recurrent hypopharyngeal squamous cell carcinoma (SCC). However, surgical salvage was only feasible for early recurrent tumor. Close follow-up surveillance to detect early recurrence is essential after primary treatment of patients.

OBJECTIVES

Despite improvements in surgery, radiotherapy, and chemotherapy, hypopharyngeal SCC has one of the worst prognoses among head and neck malignant diseases. To improve the overall survival and cure rates in patients with hypopharyngeal SCC, the management of recurrent disease as well as initial treatment is important. In this study, the efficacy and results of salvage treatment of recurrent hypopharyngeal SCC after primary curative treatment were evaluated.

METHODS

The management outcomes of 49 patients who were treated for recurrent hypopharyngeal SCC between January 2002 and December 2010 at Kyushu University Hospital were reviewed.

RESULTS

The median time for detection of recurrence from the initial curative treatment was 10.3 months (range 2.1-61.1 months). The total salvage rates of recurrence were 45% (local, 85%; locoregional, 100%; regional, 23%; distant, 19%). The 1- and 3-year tumor-free actuarial survival rates of those patients who received salvage surgery followed by chemotherapy and/or radiotherapy were 96% and 79%, respectively. There was no 3-year survivor among the patients who received only chemotherapy and/or radiotherapy.

摘要

结论

下咽鳞状细胞癌(SCC)复发后行挽救性手术有中度治愈机会。然而,挽救性手术仅适用于早期复发性肿瘤。对患者进行初始治疗后密切随访监测以发现早期复发至关重要。

目的

尽管手术、放疗和化疗有所改进,但下咽SCC仍是头颈部恶性疾病中预后最差的疾病之一。为提高下咽SCC患者的总生存率和治愈率,复发性疾病的治疗以及初始治疗都很重要。在本研究中,对经初始根治性治疗后复发的下咽SCC患者进行挽救性治疗的疗效和结果进行了评估。

方法

回顾性分析了2002年1月至2010年12月在九州大学医院接受复发性下咽SCC治疗的49例患者的治疗结果。

结果

从初始根治性治疗到复发检测的中位时间为10.3个月(范围2.1 - 61.1个月)。复发的总挽救率为45%(局部,85%;局部区域,100%;区域,23%;远处,19%)。接受挽救性手术后再进行化疗和/或放疗的患者,其1年和3年无瘤精算生存率分别为96%和79%。仅接受化疗和/或放疗的患者中无3年生存者。

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