加拿大安大略省声门上型喉癌患者治疗结果的评估：一项基于人群的研究。

Evaluation of treatment outcomes in patients with supraglottic laryngeal cancer in Ontario, Canada: A population-based study.

作者信息

Hall Stephen F, Griffiths Rebecca J

机构信息

Departments of Otolaryngology and Oncology, Queen's University, Kingston, Ontario, Canada.

Institute of Clinical Evaluative Sciences Queens, Queen's University, Kingston, Ontario, Canada.

出版信息

Head Neck. 2018 May;40(5):1024-1033. doi: 10.1002/hed.25073. Epub 2018 Feb 7.

DOI:10.1002/hed.25073

PMID:29412495

Abstract

BACKGROUND

Supraglottic laryngeal carcinoma has an entirely different etiology, clinical presentation, and prognosis compared to glottis cancer but the only evidence for the use of concurrent chemotherapy with radiotherapy (CRT) is the 5.4% 5-year improvement in overall survival (OS) for the combined laryngeal site.

METHOD

We conducted a retrospective population-based study using administrative data to compare OS, disease-specific survival (DSS), laryngectomy-free survival, and laryngoesophageal dysfunction-free survival over time and by treatment for all patients with supraglottic laryngeal carcinoma diagnosed between January 1, 1990, and December 31, 2014, in Ontario, Canada.

RESULTS

There was no improvement over time in OS (hazard ratio [HR] 1.006; P = .90), DSS (HR 1.031; P = .65), or laryngoesophageal dysfunction-free survival (P = .39). The patients selected for CRT had similar OS (HR 1.04; P = .66), laryngectomy-free survival (HR 0.95; P = .23), and laryngoesophageal dysfunction-free survival (P = .79) compared with patients undergoing radiotherapy.

CONCLUSION

The addition of CRT by head and neck oncologists in Ontario, Canada, did not improve outcomes for the "real world" patients with supraglottic laryngeal carcinoma.

摘要

背景

与声门癌相比，声门上喉癌具有完全不同的病因、临床表现和预后，但使用同步放化疗（CRT）的唯一证据是联合喉部区域的总生存率（OS）有5.4%的5年改善。

方法

我们利用行政数据进行了一项基于人群的回顾性研究，以比较1990年1月1日至2014年12月31日期间在加拿大安大略省诊断的所有声门上喉癌患者的OS、疾病特异性生存率（DSS）、无喉切除术生存率和无喉食管功能障碍生存率随时间变化及不同治疗方式的情况。

结果

OS（风险比[HR] 1.006；P = 0.90）、DSS（HR 1.031；P = 0.65）或无喉食管功能障碍生存率（P = 0.39）随时间均无改善。与接受放疗的患者相比，选择CRT治疗的患者在OS（HR 1.04；P = 0.66）、无喉切除术生存率（HR 0.95；P = 0.23）和无喉食管功能障碍生存率（P = 0.79）方面相似。