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放射治疗对无病理淋巴结转移的局部晚期喉癌的辅助作用。

Adjuvant role of radiation therapy for locally advanced laryngeal cancer without pathological lymph node metastasis.

作者信息

Kim Sung Hee, Lee Yoon Se, Kwon Minsu, Kim Ji Won, Roh Jong-Lyel, Choi Seung-Ho, Kim Sang Yoon, Lee Sang-Wook, Nam Soon Yuhl

机构信息

a Department of Otolaryngology, Asan Medical Center , University of Ulsan College of Medicine , Seoul , Republic of Korea ;

b Department of Radiation Oncology, Asan Medical Center , University of Ulsan College of Medicine , Seoul , Republic of Korea.

出版信息

Acta Otolaryngol. 2016 Jul;136(7):703-10. doi: 10.3109/00016489.2016.1146827. Epub 2016 Feb 29.

Abstract

Conclusion The application of adjuvant RT to reduce recurrence should be tailored in cases of pathologically negative node metastasis. Objectives The treatment modality following surgical resection of advanced laryngeal cancer is determined by adverse factors. Aside from lymph node metastasis (LNM) or positive margins, definite risk factors supporting adjuvant radiation therapy (RT) have not been clearly suggested. The aim of this study was to analyze the risk factors for advanced laryngeal cancer without LNM and the role of RT. Materials and methods Pathologically T3 and T4-staged laryngeal squamous cell carcinoma without LNM were reviewed. The patients were classified into RT (+) (n = 22) and RT (-) (n = 38) groups. Results Five-year overall survival (OS) of the RT (+) and RT (-) groups was 84.4% and 83.8%, respectively. Five-year disease-specific survival of the RT (+) and RT (-) groups was 88.4% and 93.9%. Five-year local control rate of the RT (+) and RT (-) groups was 94.7% and 91.3%. The factors affecting OS were smoking history and recurrence history (p = 0.02). By multivariate analysis, smoking history and recurrence history were determining factors for 5-year OS (p = 0.024 and p = 0.047, respectively).

摘要

结论 在病理检查淋巴结转移阴性的病例中,应用辅助放疗以降低复发率应个体化。目的 晚期喉癌手术切除后的治疗方式由不良因素决定。除了淋巴结转移(LNM)或切缘阳性外,支持辅助放疗(RT)的确切危险因素尚未明确。本研究的目的是分析无LNM的晚期喉癌的危险因素及放疗的作用。材料与方法 回顾性分析病理分期为T3和T4期且无LNM的喉鳞状细胞癌患者。将患者分为放疗(+)组(n = 22)和放疗(-)组(n = 38)。结果 放疗(+)组和放疗(-)组的5年总生存率(OS)分别为84.4%和83.8%。放疗(+)组和放疗(-)组的5年疾病特异性生存率分别为88.4%和93.9%。放疗(+)组和放疗(-)组的5年局部控制率分别为94.7%和91.3%。影响总生存率的因素为吸烟史和复发史(p = 0.02)。多因素分析显示,吸烟史和复发史是5年总生存率的决定因素(分别为p = 0.024和p = 0.047)。

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