Kimura Kana, Itoh Yoshiyuki, Okada Tohru, Kubota Seiji, Kawamura Mariko, Nakahara Rie, Oie Yumi, Kozai Yuka, Takase Yuuki, Tsuzuki Hidenori, Nishio Naoki, Hiramatsu Mariko, Fujimoto Yasushi, Mizutani Takefumi, Naganawa Shinji
Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Nagoya J Med Sci. 2017 Aug;79(3):331-338. doi: 10.18999/nagjms.79.3.331.
The purpose of this study was to evaluate the clinical outcomes of radiotherapy for patients with T1/T2 glottic carcinoma. Patients with T1/T2 glottic carcinoma histopathologically diagnosed with squamous cell carcinoma and treated at our hospital between 2007 and 2015 were analyzed retrospectively. Our strategy for T1/T2 glottic carcinoma was as follows: radiotherapy alone with 2.25 Gy per fraction to a total of 25-28 fractions for patients with non-bulky T1 glottic carcinoma; concurrent chemoradiotherapy with oral S-1 and radiotherapy with 2 Gy per fraction to a total of 30 fractions for patients with T1 bulky/T2 favorable glottic carcinoma; or chemoradiotherapy with high-dose cisplatin and radiotherapy with 2 Gy per fraction to a total of 35 fractions for T2 unfavorable glottic carcinoma. Forty-eight patients were eligible. The median follow-up period among surviving patients was 38 months (range, 11-107). The disease was T1a in 23%, T1b in 13%, and T2 in 65% of patients. The 3-year local control rate in all patients, T1a, T1b, and T2 was 96.7%, 100%, 100%, and 96.0%, respectively. Of the 46 patients, one with T2 glottic carcinoma developed recurrent disease at the primary site, and one with T2 glottic carcinoma had lymph node recurrences in the neck. Acute Grade 3 dermatitis occurred in 8 (17%) patients and late Grade 2 hypothyroidism occurred in 2 (4%) patients. This retrospective study shows that our optimized treatment strategy of radiotherapy depending on the stage of early glottic carcinoma is not only effective but also well-tolerated.
本研究的目的是评估T1/T2声门癌患者放射治疗的临床疗效。对2007年至2015年间在我院接受治疗、经组织病理学诊断为鳞状细胞癌的T1/T2声门癌患者进行回顾性分析。我们针对T1/T2声门癌的治疗策略如下：对于非肿块型T1声门癌患者，采用单纯放疗，每次分割剂量为2.25 Gy，总剂量为25 - 28次分割；对于T1肿块型/T2有利型声门癌患者，采用口服S-1同步放化疗，每次分割剂量为2 Gy，总剂量为30次分割；对于T2不利型声门癌患者，采用高剂量顺铂放化疗，每次分割剂量为2 Gy，总剂量为35次分割。48例患者符合条件。存活患者的中位随访期为38个月（范围11 - 107个月）。患者疾病分期为T1a的占23%，T1b的占13%，T2的占65%。所有患者、T1a、T1b和T2患者的3年局部控制率分别为96.7%、100%、100%和96.0%。46例患者中，1例T2声门癌患者在原发部位出现复发疾病，1例T2声门癌患者颈部出现淋巴结复发。8例（17%）患者发生急性3级皮炎，2例（4%）患者发生晚期2级甲状腺功能减退。这项回顾性研究表明，我们根据早期声门癌分期优化的放射治疗策略不仅有效，而且耐受性良好。
