Department of Head and Neck Surgery, Hyogo Cancer Center, 13-70 Kitaoji, Akashi, Hyogo, 673-8558, Japan.
Department of Otolaryngology, Eiju General Hospital, Tokyo, Japan.
Int J Clin Oncol. 2017 Dec;22(6):1001-1008. doi: 10.1007/s10147-017-1151-9. Epub 2017 Jun 17.
The aim of this study was to compare the therapeutic outcomes of total pharyngolaryngectomy with those of concomitant chemoradiotherapy in advanced hypopharyngeal cancer.
This is a retrospective multi-institutional study. The medical records of 979 patients with hypopharyngeal cancer, who were initially treated between 2006 and 2008, were reviewed. In this study, we matched a group of total pharyngolaryngectomy patients with a second group of chemoradiotherapy patients, according to age, gender, subsite, arytenoid fixation, cartilage invasion, and N classification, and analyzed overall survival, disease-specific survival, and locoregional control rates.
The matched-pair analysis included 254 patients. The 5-year overall survival, disease-specific survival, and locoregional control rates were 58.5% and 53.5% (P = 0.30), 68.9% and 68.0% (P = 0.80), and 82.2% and 63.6% (P < 0.01), respectively, for patients in the total pharyngolaryngectomy and chemoradiotherapy groups. For T4a patients with cartilage invasion, the matched-pair analysis included 46 patients. The 5-year overall survival, disease-specific, and locoregional control rates were 56.5% and 26.0% (P = 0.092), 56.5% and 41.3% (P = 0.629), and 43.0% and 42.5% (P = 0.779), respectively, for patients in the total pharyngolaryngectomy and chemoradiotherapy groups.
The data from this large-scale multi-institutional joint research program of hypopharyngeal cancer in Japan suggest that chemoradiotherapy may provide adequate survival benefit for hypopharyngeal cancer patients with the distinct advantage of larynx preservation. Our data also suggest that chemoradiotherapy is as beneficial as total pharyngolaryngectomy for the local control of locally advanced hypopharyngeal cancer.
本研究旨在比较全咽-喉切除术与同期放化疗治疗晚期下咽癌的疗效。
这是一项回顾性多中心研究。对 979 例下咽癌患者的病历资料进行了回顾性分析，这些患者于 2006 年至 2008 年间首次接受治疗。在本研究中，我们根据年龄、性别、部位、杓状软骨固定、软骨侵犯和 N 分类，将全咽-喉切除术患者与同期放化疗患者进行匹配，并分析了总生存率、疾病特异性生存率和局部区域控制率。
配对分析包括 254 例患者。全咽-喉切除术组和同期放化疗组患者的 5 年总生存率、疾病特异性生存率和局部区域控制率分别为 58.5%和 53.5%（P=0.30）、68.9%和 68.0%（P=0.80）和 82.2%和 63.6%（P<0.01）。对于有软骨侵犯的 T4a 患者，配对分析包括 46 例患者。全咽-喉切除术组和同期放化疗组患者的 5 年总生存率、疾病特异性生存率和局部区域控制率分别为 56.5%和 26.0%（P=0.092）、56.5%和 41.3%（P=0.629）和 43.0%和 42.5%（P=0.779）。
来自日本大规模多中心下咽癌联合研究计划的数据表明，同期放化疗可为下咽癌患者提供充分的生存获益，其优势在于保留了喉。我们的数据还表明，同期放化疗在局部晚期下咽癌的局部控制方面与全咽-喉切除术同样有益。
