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早期下咽鳞状细胞癌的根治性放疗

Definitive radiotherapy for early-stage hypopharyngeal squamous cell carcinoma.

作者信息

Sato Kaname, Kubota Akira, Furukawa Madoka, Kitani Yousuke, Nakayama Yuko, Nonaka Tetsuo, Mizoguchi Nobutaka, Shiomi Miho

机构信息

Department of Head and Neck Surgery, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, Kanagawa, 241-8515, Japan,

出版信息

Eur Arch Otorhinolaryngol. 2015 Aug;272(8):2001-6. doi: 10.1007/s00405-014-3132-1. Epub 2014 Jun 18.

Abstract

The present study analyzed the outcomes of patients with early-stage hypopharyngeal squamous cell carcinoma (HPSCC) treated with radical radiotherapy (RT) or concurrent chemoradiotherapy (CCRT). We retrospectively reviewed the clinical records of 33 patients with early-stage HPSCC who underwent RT or CCRT between January 1999 and December 2011. Of the 33 patients who were treated, 12 had Stage I and 21 had Stage II disease. Patients with Stage I were typically treated with RT, while patients with Stage II were treated with CCRT (concurrent chemotherapy: 5FU, cisplatin or TS-1). The median follow-up period was 81 months, ranging from 15 to 155 months. The 5-year overall survival rates, cause specific survival rates, locoregional control rates, and progression-free survival rates were 58, 75, 56, and 49 %, respectively. Of the 33 patients, 51 % experienced second primary malignancies. Esophageal carcinoma occurred in several cases, and was diagnosed either during screening after treatment for the second primary malignancy or simultaneously with the second primary malignancy. Advanced-stage second malignancies significantly influenced the survival of the patients and the control rate for HPSCC. Treatment emphasizing the quality of life after treatment is needed, if a poor prognosis is expected because of advanced-stage second primary malignancy.

摘要

本研究分析了接受根治性放疗(RT)或同步放化疗(CCRT)的早期下咽鳞状细胞癌(HPSCC)患者的治疗结果。我们回顾性分析了1999年1月至2011年12月期间接受RT或CCRT的33例早期HPSCC患者的临床记录。在接受治疗的33例患者中,12例为I期,21例为II期。I期患者通常接受RT治疗,而II期患者接受CCRT治疗(同步化疗:5-氟尿嘧啶、顺铂或替吉奥)。中位随访期为81个月,范围为15至155个月。5年总生存率、病因特异性生存率、局部区域控制率和无进展生存率分别为58%、75%、56%和49%。在33例患者中,51%发生了第二原发性恶性肿瘤。食管癌发生了几例,在第二原发性恶性肿瘤治疗后的筛查期间或与第二原发性恶性肿瘤同时被诊断出来。晚期第二原发性恶性肿瘤显著影响患者的生存和HPSCC的控制率。如果因晚期第二原发性恶性肿瘤而预期预后不良,则需要强调治疗后生活质量的治疗。

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