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早期声门癌患者接受初始放疗并通过保守手术挽救后的治疗结果。

Treatment outcomes of the patients with early glottic cancer treated with initial radiotherapy and salvaged by conservative surgery.

作者信息

Harada Aya, Sasaki Ryohei, Miyawaki Daisuke, Yoshida Kenji, Nishimura Hideki, Ejima Yasuo, Kitajima Kazuhiro, Saito Miki, Otsuki Naoki, Nibu Ken-Ichi

机构信息

Division of Radiation Oncology, Kobe University Graduate School of Medicine, Kobe.

Division of Radiation Oncology, Kobe University Graduate School of Medicine, Kobe

出版信息

Jpn J Clin Oncol. 2015 Mar;45(3):248-55. doi: 10.1093/jjco/hyu203. Epub 2014 Dec 11.

Abstract

OBJECTIVE

This retrospective study analyzed the oncological and treatment outcomes of the patients with T1-T2N0 glottic cancer, who were treated with radiotherapy as initial treatment and salvaged by conservative surgery for radiation failure.

METHODS

Between May 1999 and December 2010, 115 patients with glottic laryngeal cancer were treated at Kobe University Hospital. At presentation, 54 patients had stage T1a disease, 26 had stage T1b disease and 35 had stage T2 disease. Seventy-nine patients were treated with conventional radiotherapy and 36 patients were treated with hyperfractionated radiotherapy as initial treatment.

RESULTS

Median duration of follow-up was 61 months. Five-year local control rates of radiotherapy were 92% in T1a, 83% in T1b and 86% in T2. Of 12 patients who developed local recurrence, larynx was successfully preserved in 3 patients by laryngomicrosurgery, 7 patients by vertical partial laryngectomy and one patient by subtotal laryngectomy. Ultimate 5-year laryngeal preservation rate and local control rate of all cases were 99 and 100%, respectively.

CONCLUSIONS

Present results suggest that initial treatment with radiotherapy salvaged by organ preservation surgery is an effective strategy for laryngeal preservation in the treatment of T1-T2N0 glottic laryngeal cancer.

摘要

目的

本回顾性研究分析了T1-T2N0声门癌患者的肿瘤学及治疗结果,这些患者初始接受放射治疗,放疗失败后采用保守手术挽救治疗。

方法

1999年5月至2010年12月期间,神户大学医院治疗了115例声门喉癌患者。初诊时,54例患者为T1a期疾病,26例为T1b期疾病,35例为T2期疾病。79例患者初始接受常规放疗,36例患者初始接受超分割放疗。

结果

中位随访时间为61个月。放疗的5年局部控制率在T1a期为92%,T1b期为83%,T2期为86%。在12例发生局部复发的患者中,3例通过喉显微手术成功保留喉,7例通过垂直部分喉切除术保留喉,1例通过次全喉切除术保留喉。所有病例的最终5年喉保留率和局部控制率分别为99%和100%。

结论

目前的结果表明,对于T1-T2N0声门喉癌的治疗,初始采用放射治疗并通过器官保留手术挽救是一种有效的喉保留策略。

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