T4期喉癌患者接受根治性放疗与根治性喉切除术的临床结局
Clinical outcomes in patients with T4 laryngeal cancer treated with primary radiotherapy versus primary laryngectomy.
作者信息
Vengalil Salil, Giuliani Meredith E, Huang Shao Hui, McNiven Andrea, Song Yuyao, Xu Wei, Chan Biu, Hope Andrew, Cho John, Bayley Andrew, Ringash Jolie, Goldstein David, Razak Albiruni, Irish Jonathan, Gilbert Ralph, Gullane Patrick, Waldron John, Kim John, O'Sullivan Brian
机构信息
Department of Radiation Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Ontario, Canada.
Department of Clinical Oncology, Royal Stoke University Hospital, University Hospital North Midlands NHS Trust, Stoke-on-Trent, United Kingdom.
出版信息
Head Neck. 2016 Apr;38 Suppl 1:E2035-40. doi: 10.1002/hed.24374. Epub 2016 Feb 1.
BACKGROUND
The purpose of this study was to determine the clinical outcomes of T4 laryngeal cancers.
METHODS
T4 laryngeal cancers treated with curative intent from January 2003 to December 2010 were analyzed. Outcomes were evaluated in both primary radiotherapy (+/- chemotherapy) (RT/CRT) and primary surgery cohorts.
RESULTS
Among the 65 primary RT/CRT and 42 primary surgery patients included, median follow-up was 4.4 years. There was a trend for improved locoregional control with surgery (74% vs 88%; p = .08). In the RT/CRT group the 3-year laryngectomy-free survival was 67%. The 2-year gastrostomy dependency rate was 23% with RT/CRT versus 6% with primary surgery (p = .07). Overall survival (OS) at 3 years was significantly lower in the RT/CRT versus primary surgery group (41% vs 70%; p < .01).
CONCLUSION
Laryngeal preservation is achieved in over two thirds of patients with primary RT/CRT. Patients with low volume minimal cartilage involvement T4 disease may be best suited to RT/CRT. © 2016 Wiley Periodicals, Inc. Head Neck 38: E2035-E2040, 2016.
背景
本研究旨在确定T4期喉癌的临床疗效。
方法
对2003年1月至2010年12月期间接受根治性治疗的T4期喉癌患者进行分析。对主要放疗（±化疗）（RT/CRT）组和主要手术组的疗效进行评估。
结果
纳入的65例主要接受RT/CRT治疗的患者和42例主要接受手术治疗的患者中，中位随访时间为4.4年。手术组在局部区域控制方面有改善趋势（74%对88%；p = 0.08）。在RT/CRT组中，3年无喉切除术生存率为67%。RT/CRT组2年胃造口依赖率为23%，而主要手术组为6%（p = 0.07）。RT/CRT组3年总生存率（OS）显著低于主要手术组（41%对70%；p < 0.01）。
结论
超过三分之二接受主要RT/CRT治疗的患者实现了喉保留。肿瘤体积小、软骨受累程度轻的T4期疾病患者可能最适合RT/CRT治疗。©2016威利期刊公司。《头颈》38: E2035 - E2040, 2016。
Zotero 插件