Kurpeshev O K, Andreev V G, Pankratov V A, Gulidov I A, Orlova A V
Vopr Onkol. 2013;59(6):721-4.
This paper analyzes the results of combined treatment with preoperative thermochemoradiotherapy in 28 patients with locally advanced laryngeal cancer (T3-4N0-3M0). Radiation therapy (RT) 32 Gy was carried out 5 times a week with splitting the daily dose of radiation on the 2 factions (interval 4 hours) on a "1 Gy + 1 Gy," in the days of the local hyperthermia (LGT)--on a "1 Gy + 3 Gy". LGT in an amount of 3-4 sessions was performed two times a week before the 2nd fraction of RT. The course of polychemotherapy was administered concurrently with RT and LGT. In 2-3 weeks after completion of the course thermochemoradiotherapy patients were operated. Organ-saving operations were performed 10 (56%) of 18 patients with primary tumors categories T3 and 2 (20%) of 10 with T4. Postoperative wounds healed by first intention in 21 (75%) patients. The cumulative 5-year overall survival in the whole group (T3-4N0-3) was 89%, for patients without regional metastases (T3-4N0)--100%. Relapse-free survival time for those patients with a primary tumor T3 equaled 94%, T4--90%. Relapse metastases occurred in 20% of patients. Thus, preoperative thermochemoradiotherapy is a highly effective method of treatment for locally advanced cancer of the larynx and does not lead to the development of severe postoperative complications.
本文分析了28例局部晚期喉癌（T3 - 4N0 - 3M0）患者术前热化疗放疗联合治疗的结果。放疗（RT）32 Gy，每周进行5次，每日放疗剂量分2次给予（间隔4小时），采用“1 Gy + 1 Gy”，在局部热疗（LGT）当天采用“1 Gy + 3 Gy”。在放疗第2次分割前，每周进行2次，共进行3 - 4次LGT。多疗程化疗与放疗和LGT同时进行。热化疗放疗疗程结束后2 - 3周对患者进行手术。18例T3期原发性肿瘤患者中有10例（56%）、10例T4期患者中有2例（20%）进行了保喉手术。21例（75%）患者术后伤口一期愈合。全组（T3 - 4N0 - 3）5年总生存率为89%，无区域转移患者（T3 - 4N0）为100%。原发性肿瘤为T3期的患者无复发生存时间为94%，T4期为90%。20%的患者出现复发转移。因此，术前热化疗放疗是治疗局部晚期喉癌的一种高效方法，且不会导致严重术后并发症的发生。
