一项新辅助化疗联合经口机器人手术治疗 T3 和 T4 喉咽癌患者的临床试验。
A Clinical Trial of Combination Neoadjuvant Chemotherapy and Transoral Robotic Surgery in Patients with T3 and T4 Laryngo-Hypopharyngeal Cancer.
机构信息
Department of Otorhinolaryngology-Head and Neck Surgery, Korea University College of Medicine, Seoul, Korea.
Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Korea.
出版信息
Ann Surg Oncol. 2018 Apr;25(4):864-871. doi: 10.1245/s10434-017-6208-5. Epub 2017 Oct 30.
BACKGROUND
We conducted a prospective clinical trial of combination neoadjuvant chemotherapy, transoral robotic surgery (TORS), and customized adjuvant therapy in patients with locally advanced laryngo-hypopharyngeal cancer.
METHODS
Between September 2008 and August 2016, 35 patients were enrolled in this clinical trial.
RESULTS
Twenty patients had hypopharyngeal cancer and 15 had laryngeal cancer. Twenty-nine patients (82.9%) had T3 disease and six patients (17.1%) had T4 disease, while 12 patients (34.3%) had stage III disease and 23 patients (65.7%) had stage IV disease. The 3-year disease-specific survival rate was 82.4% and the 3-year disease-free survival rate was 69.48%. Decannulation was successful in 31 of 34 patients at an average of 18 days postoperatively. Among all patients, 83% exhibited a favorable subjective swallowing status, while five patients (14.4%) became dependent on feeding tubes.
CONCLUSIONS
Neoadjuvant chemotherapy combined with TORS and customized adjuvant therapy, based on detailed pathological information, afforded favorable oncological outcomes and preserved organ functionalities in T3-T4 laryngo-hypopharyngeal cancer.
背景
我们进行了一项前瞻性临床试验，对局部晚期喉咽癌患者采用新辅助化疗联合经口机器人手术（TORS）和定制辅助治疗。
方法
2008 年 9 月至 2016 年 8 月，共有 35 例患者入组该临床试验。
结果
20 例为下咽癌，15 例为喉癌。29 例（82.9%）患者为 T3 期疾病，6 例（17.1%）患者为 T4 期疾病，12 例（34.3%）患者为 III 期疾病，23 例（65.7%）患者为 IV 期疾病。3 年疾病特异性生存率为 82.4%，3 年无病生存率为 69.48%。术后平均 18 天，34 例患者中有 31 例成功拔管。所有患者中，83%的主观吞咽状况良好，5 例（14.4%）患者需要依赖饲管。
结论
基于详细的病理信息，新辅助化疗联合 TORS 和定制辅助治疗为 T3-T4 喉咽癌患者提供了良好的肿瘤学结果和器官功能保留。
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