Department of Otolaryngology, University of Florida, Gainesville, FL, USA; University of Florida Health Cancer Center, Gainesville, FL, USA.
Department of Otolaryngology, University of Florida, Gainesville, FL, USA.
Oral Oncol. 2018 Apr;79:47-54. doi: 10.1016/j.oraloncology.2018.02.015. Epub 2018 Feb 22.
The optimal treatment for T3 glottic cancers continues to be debated. Organ preservation has become the standard of care, but not all tumors respond equally. The purpose of this was to investigate the long-term survival outcomes of organ preservation protocols based on tumor volume.
A retrospective review of prospectively collected data from 1966 to 2016 was performed. Patients with T3 vocal cord cancer treated with radiation therapy (RT) at the University of Florida were included. Local control rates as well as survival rates were determined with a Kaplan Meier and Cox regression analysis. Survival was analyzed as a function of tumor volume and an optimal cut point was determined.
107/234 patients were included. 79% received RT and 21% chemo-RT. 5-year local control was 61.5% and 5-year disease specific survival was 79.3%. Tumor volume was a significant predictor of survival (p = 0.007). An optimal cut point for tumor volume was 2.5 cc. Patients with tumor volumes ≥2.5 cc had significantly worse (p < 0.05) tumor control rates (100% vs. 70.4%).
Tumor volume is a significant predictor of survival outcomes in T3 vocal cord cancers, but will need external validation. Tumors <2.5 cc have favorable outcomes. Those with higher volume tumors should be counselled appropriately and be considered for primary surgical management.
T3 声门型癌症的最佳治疗方法仍存在争议。保留器官已成为治疗标准，但并非所有肿瘤的反应都一样。本研究旨在探讨基于肿瘤体积的器官保留方案的长期生存结果。
对 1966 年至 2016 年期间前瞻性收集的数据进行回顾性分析。纳入在佛罗里达大学接受放射治疗（RT）治疗的 T3 声带癌患者。采用 Kaplan-Meier 和 Cox 回归分析确定局部控制率和生存率。生存分析作为肿瘤体积的函数，并确定最佳截断点。
共纳入 234 例患者中的 107 例。79%接受 RT，21%接受化疗-RT。5 年局部控制率为 61.5%，5 年疾病特异性生存率为 79.3%。肿瘤体积是生存的显著预测因素（p=0.007）。肿瘤体积的最佳截断点为 2.5cc。肿瘤体积≥2.5cc 的患者肿瘤控制率显著更差（p<0.05）（100% vs. 70.4%）。
肿瘤体积是 T3 声带癌生存结果的重要预测因素，但需要外部验证。体积<2.5cc 的肿瘤预后良好。那些体积较大的肿瘤应适当告知，并考虑进行主要手术治疗。
