Gao Pei, Gong Liang, Wang Xuefeng
Department of Otolaryngology, Jinzhou Medical University, Jinzhou, Liaoning 121000, P.R. China.
Department of Otolaryngology, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning 121000, P.R. China.
Mol Clin Oncol. 2018 Aug;9(2):155-162. doi: 10.3892/mco.2018.1645. Epub 2018 Jun 5.
Head and neck squamous cell carcinoma (SCC) ranks 6th among the most frequently diagnosed carcinomas globally. Laryngeal carcinoma is quite common, and 95% of the cases are SCCs. Since the introduction of larynx-preserving surgery, induction chemotherapy (IC) has played a substantial role. The aim of IC is to shrink or downstage primary laryngeal carcinomas, increasing the chances of complete surgical removal, particularly in cases with advanced but potentially resectable lesions. The aim of the present study was to investigate the value of IC in patients with resectable laryngeal cancer. A meta-analysis was performed of randomized controlled trials (1985-2017) investigating the effect of IC on survival, disease control, larynx-preserving surgery and disease-free survival. Engauge-Digitizer software was used to construct Kaplan-Meier curves and RevMan software was used for the analysis of the data. A total of 12 trials (4,320 patients) were included. There was no significant difference in local recurrence or locoregional control between patients receiving and those not receiving IC (P>0.05). However, the experimental group (IC) exhibited a lower propensity for distant metastasis by 11.7% (95% confidence interval: 10.3-13.3%, P=0.02) compared with the control group (no IC). Among patients with laryngeal cancer, larynx preservation was possible in those who responded well to IC, without a significant decrease in survival compared with radical surgery (P<0.05). Taking into consideration these findings, IC confers an advantage in terms of lowering the risk of distant metastasis in patients with resectable laryngeal carcinoma, and enables laryngeal preservation in responders. Moreover, IC increases the overall survival rate in patients with locally advanced but resectable LC.
头颈部鳞状细胞癌（SCC）在全球最常诊断出的癌症中排名第六。喉癌相当常见，其中95%的病例为鳞状细胞癌。自引入保喉手术以来，诱导化疗（IC）发挥了重要作用。IC的目的是缩小原发性喉癌或使其降期，增加完全手术切除的机会，特别是对于晚期但有可能切除的病变。本研究的目的是探讨IC在可切除喉癌患者中的价值。对1985年至2017年调查IC对生存、疾病控制、保喉手术和无病生存影响的随机对照试验进行了荟萃分析。使用Engauge-Digitizer软件构建Kaplan-Meier曲线，使用RevMan软件进行数据分析。共纳入12项试验（4320例患者）。接受IC和未接受IC的患者在局部复发或区域控制方面无显著差异（P>0.05）。然而，与对照组（未接受IC）相比，实验组（IC）远处转移的倾向降低了11.7%（95%置信区间：10.3 - 13.3%，P = 0.02）。在喉癌患者中，对IC反应良好的患者可以保留喉部，与根治性手术相比，生存率没有显著下降（P<0.05）。考虑到这些发现，IC在降低可切除喉癌患者远处转移风险方面具有优势，并能使反应者保留喉部。此外，IC提高了局部晚期但可切除的喉癌患者的总生存率。
