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如果面对晚期喉癌,放射肿瘤学家会考虑哪种选择?

[Which choice would the radiation oncologist consider if facing an advanced stage laryngeal cancer?].

作者信息

Giraud P, Malinvaud D, Ménard M, Consoli S, Bonfils P, Laccourreye O

机构信息

Service d'oncologie-radiothérapie, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France; Université Paris Descartes, Paris Cité Sorbonne, 75015 Paris, France.

Université Paris Descartes, Paris Cité Sorbonne, 75015 Paris, France; Service d'oto-rhino-laryngologie et de chirurgie cervico-faciale, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France.

出版信息

Cancer Radiother. 2014 Nov;18(7):649-54. doi: 10.1016/j.canrad.2014.05.013. Epub 2014 Oct 7.

Abstract

PURPOSE

To analyse the therapeutic decision considered by radiation oncologists put in a position of being diagnosed with an advanced stage cancer of the larynx accessible either to a total laryngectomy or to an organ preservation protocol.

MATERIALS AND METHODS

Prospective analysis based on an anonymous survey filled by 104 radiation oncologists.

RESULTS

A total of 30.7% of radiation oncologists surveyed did not consider any trade in their cure rate to preserve their larynx. The median percentage of cure that they were willing to trade was 10% (2-100%); and 0.9% of them were willing to trade 100% of their chance for cure in order to "avoid" total laryngectomy. A total of 16.3% of radiation oncologists would like to receive more information before making their decision. The additional information most frequently requested concerned the precise stage of the tumour and the potential remedial treatment in case of failure of the laryngeal preservation protocol. None of the analysed demographic variables influenced the choice to trade or not survival chance to preserve the larynx, the percentage of chance that radiation oncologists would consider exchanging, and/or the wish to receive additional information.

CONCLUSION

This prospective study highlights that larynx preservation protocol is not the main therapeutic goal shared by all radiation oncologists put in a position of being diagnosed with an advanced stage cancer of the larynx. Total laryngectomy should remain a treatment option that as organ preservation protocols to be proposed and discussed.

摘要

目的

分析放疗肿瘤学家在面临被诊断为晚期喉癌时所考虑的治疗决策,晚期喉癌可选择全喉切除术或器官保留方案。

材料与方法

基于104名放疗肿瘤学家填写的匿名调查问卷进行前瞻性分析。

结果

共有30.7%的受访放疗肿瘤学家在保留喉部时不考虑对治愈率进行任何权衡。他们愿意权衡的治愈率中位数为10%(2%-100%);其中0.9%的人愿意以100%的治愈机会为代价来“避免”全喉切除术。共有16.3%的放疗肿瘤学家希望在做出决定前获得更多信息。最常要求的额外信息涉及肿瘤的精确分期以及喉保留方案失败时的潜在补救治疗。所分析的人口统计学变量均未影响以保留喉部为目的而权衡生存机会的选择、放疗肿瘤学家会考虑交换的机会百分比以及获取额外信息的意愿。

结论

这项前瞻性研究表明,对于所有面临被诊断为晚期喉癌的放疗肿瘤学家来说,喉保留方案并非主要的治疗目标。全喉切除术应仍然是一种治疗选择,与器官保留方案一样需要提出并进行讨论。

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