Denaro Nerina, Russi Elvio Grazioso, Lefebvre Jean Louis, Merlano Marco Carlo
Oncology Department, ASO Santa Croce e Carle, Italy.
Radiation Oncology, ASO Santa Croce e Carle, Italy.
Radiother Oncol. 2014 Jan;110(1):16-24. doi: 10.1016/j.radonc.2013.08.016. Epub 2013 Oct 15.
Treatment options targeting laryngeal preservation include conservative surgery, concurrent chemo-radiotherapy, induction chemotherapy (IC) followed by radiotherapy (RT), and alternating chemo-radiation. The goal of this paper was to perform a systematic review of randomized clinical trials (RCTs) on current and emerging approaches in the field of larynx preservation. The search identified 36 papers of which 27 did not fall within the inclusion criteria (i.e. non-RCTs). IC followed by RT has been shown to allow laryngeal preservation in about two-thirds of pts with locally advanced laryngeal or hypopharyngeal cancer without compromising survival. IC is regarded as the landmark treatment of non-surgical larynx preservation approaches. Concomitant and alternating chemoradiotherapy treatments are also acceptable in larynx preservation.
针对保留喉功能的治疗选择包括保守手术、同步放化疗、诱导化疗(IC)后放疗(RT)以及交替放化疗。本文的目的是对喉保留领域当前和新出现方法的随机临床试验(RCT)进行系统评价。检索到36篇论文,其中27篇不符合纳入标准(即非RCT)。已证明IC后RT可使约三分之二的局部晚期喉癌或下咽癌患者保留喉功能,且不影响生存率。IC被视为非手术喉保留方法的标志性治疗。同步和交替放化疗在喉保留中也是可接受的。