Zumsteg Zachary S, Riaz Nadeem, Jaffery Sana, Hu Man, Gelblum Daphna, Zhou Ying, Mychalczak Borys, Zelefsky Michael J, Wolden Suzanne, Rao Shyam, Lee Nancy Y
Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY, United States.
Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY, United States.
Oral Oncol. 2015 Jul;51(7):716-23. doi: 10.1016/j.oraloncology.2015.02.003. Epub 2015 May 7.
Although intensity-modulated radiotherapy (IMRT) is a standard of care for many head and neck cancers, its use for carotid-sparing (CS) therapy in early-stage laryngeal carcinoma is controversial.
330 consecutive patients with early-stage laryngeal carcinoma were treated from 1/1989 to 5/2011, including 282 conventional radiotherapy (CRT) and 48 CS-IMRT patients. The median follow-up was 43 (CS-IMRT) and 66 (CRT) months.
There was no difference in local failure rates comparing patients undergoing CS-IMRT with CRT, with 3-year local control rates of 88% vs. 89%, respectively (p=0.938). Using a 1cm circumferential margin, the average dose to the left and right carotid arteries was 48.3 and 47.9 Gy, respectively. 88% of locoregional recurrences involved the ipsilateral true vocal cord, including all local recurrences in the IMRT group.
These results warrant further prospective evaluation of CS-IMRT for early-stage glottic larynx cancer.
尽管调强放射治疗（IMRT）是许多头颈癌的标准治疗方法，但其在早期喉癌的保留颈动脉（CS）治疗中的应用仍存在争议。
1989年1月至2011年5月期间，连续治疗了330例早期喉癌患者，其中包括282例接受传统放疗（CRT）的患者和48例接受CS-IMRT的患者。中位随访时间分别为43个月（CS-IMRT组）和66个月（CRT组）。
接受CS-IMRT的患者与接受CRT的患者相比，局部失败率没有差异，3年局部控制率分别为88%和89%（p=0.938）。采用1厘米的环形边缘，左、右颈动脉的平均剂量分别为48.3 Gy和47.9 Gy。88%的局部区域复发累及同侧真声带，包括IMRT组的所有局部复发。
这些结果值得对CS-IMRT在早期声门型喉癌中的应用进行进一步的前瞻性评估。
