Horwitz S D, Caldarelli D D, Hendrickson F R
Head Neck Surg. 1979 Nov-Dec;2(2):107-11. doi: 10.1002/hed.2890020205.
In a review of 80 patients with hypopharyngeal squamous-cell carcinoma, 43 patients were found to have had lesions arising in the pyriform sinus, 34 had lesions arising on the postcollateral wall of the hypopharynx, and 3 had lesions in the postcricoid area. Therapeutic modalities included radical radiation therapy in 56 patients, radiation plus surgery in 13 patients, and planned combined therapy in 11 patients. The five-year determinate survival rate of all the patients was 20%. Patients with posterolateral wall tumors had a 23% rate of cure, but those with pyriform sinus tumors had only a 13% rate of cure. The five-year determinant survival rate was 12.5% for patients undergoing radical radiation therapy, 15.4% for those undergoing unplanned radiation and surgery (salvage therapy), and 55.6% for those with planned combined therapy. Over 40% of the patients had a recurrence of their disease; an additional 20% developed distant metastatic spread which usually occurred within the first year. The type of therapy did not alter the rate of recurrence but did affect the rate of distant metastatic spread, with planned combined therapy greatly improving control of the primary lesion. This study suggests that, even with advanced disease, the most effective therapy for hypopharyngeal carcinoma is planned combined radiation therapy and surgery.
在一项对80例下咽鳞状细胞癌患者的回顾性研究中，发现43例患者的病变发生在梨状窦，34例患者的病变发生在下咽后侧壁，3例患者的病变发生在环状软骨后区。治疗方式包括56例患者接受根治性放射治疗，13例患者接受放疗加手术，11例患者接受计划性联合治疗。所有患者的五年确定生存率为20%。后外侧壁肿瘤患者的治愈率为23%，但梨状窦肿瘤患者的治愈率仅为13%。接受根治性放射治疗的患者五年确定生存率为12.5%，接受非计划性放疗和手术（挽救性治疗）的患者为15.4%，接受计划性联合治疗的患者为55.6%。超过40%的患者疾病复发；另外20%发生远处转移扩散，通常发生在第一年。治疗方式并未改变复发率，但确实影响远处转移扩散率，计划性联合治疗大大改善了对原发病变的控制。这项研究表明，即使是晚期疾病，下咽癌最有效的治疗方法是计划性联合放疗和手术。
