Kelly M D, Hahn S S, Spaulding C A, Kersh C R, Constable W C, Cantrell R W
Division of Therapeutic Radiology and Oncology, University of Virginia Health Sciences Center, Charlottesville 22908.
Ann Otol Rhinol Laryngol. 1989 Mar;98(3):235-9. doi: 10.1177/000348948909800314.
Definitive radiotherapy for early glottic carcinoma continues to offer excellent control and the advantage of voice preservation. In the 13 years from January 1972 through December 1984, there were 187 patients diagnosed with squamous cell carcinoma of the glottis at the University of Virginia Medical Center. One hundred forty-eight patients were treated with definitive radiotherapy as the initial management. The 3-year disease-free survival for the irradiated population was 93.6% in stage I and 75.5% in stage II. Twenty patients had recurrences following radiotherapy, and 13 of 20 were successfully surgically salvaged for an overall determinate survival of 100% in stage I and 85.7% in stage II at 3 years. These statistics are comparable to those from our previous 16-year review of 147 patients from 1956 through 1971. Factors of prognostic significance were persistent hoarseness after radiotherapy, impaired cord mobility, subglottic extension, and multiple sites of involvement in stage I. We conclude that definitive radiotherapy offers excellent survival and that a majority of the small number of treatment failures can be managed with surgical salvage.
早期声门癌的根治性放疗持续提供良好的控制效果以及保留嗓音的优势。在1972年1月至1984年12月的13年间，弗吉尼亚大学医学中心有187例患者被诊断为声门鳞状细胞癌。148例患者接受了根治性放疗作为初始治疗。照射人群的3年无病生存率在I期为93.6%，在II期为75.5%。20例患者放疗后复发，其中13例通过手术成功挽救，I期3年时总体确定生存率为100%，II期为85.7%。这些统计数据与我们之前对1956年至1971年147例患者进行的16年回顾结果相当。具有预后意义的因素包括放疗后持续声音嘶哑、声带活动受限、声门下扩展以及I期多部位受累。我们得出结论，根治性放疗可提供良好的生存率，并且少数治疗失败病例中的大多数可以通过手术挽救进行处理。
