Kurpeshev O K, Andreev V G, Pankratov V A, Gulidov I A, Orlova A V
Vopr Onkol. 2014;60(5):602-6.
There were analyzed results of treatment of 58 patients with laryngeal cancer T3-4N0-3M0. Chemoradiotherapy (CRT) was carried out in 27 patients, thermochemoradiotherapy (TCRT)-in 31 patients. Radiotherapy (RT) was performed in hyperfractionated mode (1 Gy + 1 Gy with an interval of 4-5 hours) 5 times a week to CTD 52-60 Gy with a 2-week break after CTD 30-40 Gy. Local hyperthermia (LHT) was carried out 2 times a week before the second fraction of RT in an amount of 3-6 sessions. The first cycle of polychemotherapy was administered at the beginning of RT and the second one-after the break. The local control under the primary tumor category T3 after CRT was equal to 58% and after TCRT--88%, at T4--72% and 25%, respectively. Late radiation damage of the larynx in the form of mucosal edema and perichondritis after CRT was in 2 patients (7%) and after TCRT--in 3 patients (10%). Thus, TCRT for locally advanced laryngeal cancer allows obtaining a higher overall survival and a local control as compared to CRT and does not lead to a significant increase of frequency of perichondritis.
分析了58例T3 - 4N0 - 3M0期喉癌患者的治疗结果。27例患者接受了放化疗（CRT），31例患者接受了热化疗放疗（TCRT）。放疗（RT）采用超分割模式（1戈瑞+ 1戈瑞，间隔4 - 5小时），每周5次，总剂量达52 - 60戈瑞，在总剂量达30 - 40戈瑞后休息2周。在放疗第二次分割前每周进行2次局部热疗（LHT），共3 - 6次。多药化疗的第一个周期在放疗开始时给药，第二个周期在休息后给药。CRT后T3期原发肿瘤的局部控制率为58%，TCRT后为88%；T4期分别为72%和25%。CRT后有2例患者（7%）出现以黏膜水肿和软骨膜炎形式的晚期喉部放射性损伤，TCRT后有3例患者（10%）出现。因此，与CRT相比，局部晚期喉癌的TCRT可获得更高的总生存率和局部控制率，且不会导致软骨膜炎发生率显著增加。
