保留器官和功能的放射治疗在喉腺样囊性癌治疗中的作用。
The role of organ- and function-preserving radiotherapy in the treatment of adenoid cystic carcinoma of the larynx.
作者信息
Akbaba Sati, Lang Kristin, Bulut Olcay Cem, Held Thomas, Rieken Stefan, Plinkert Peter, Jensen Alexandra, Herfarth Klaus, Debus Juergen, Adeberg Sebastian
机构信息
Department of Radiation Oncology, University Hospital Heidelberg, Heidelberg, Germany.
Department of Radiation Oncology, Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany.
出版信息
Head Neck. 2019 Jul;41(7):2208-2214. doi: 10.1002/hed.25678. Epub 2019 Feb 5.
BACKGROUND
To evaluate clinical outcome and functional larynx preservation after radiotherapy (RT) for adenoid cystic carcinoma (ACC) of the larynx.
METHODS
Eleven patients with primary ACC of the larynx, who received RT definitely (n = 5/11) or postoperatively (n = 6/11), were analyzed regarding survival and treatment-related toxicity with the focus on functional larynx preservation.
RESULTS
Median follow-up was 45 months. RT offered an excellent 5-year local control (LC) rate of 100%. Eight of 11 patients were treated with a laryngeal preservation approach (LPA). At last follow-up, only one of these eight patients developed a local recurrence requiring a total laryngectomy 11 years after treatment. Severe toxicity was uncommon, with only one patient with LPA, requiring a temporary tracheostomy during therapy.
CONCLUSIONS
RT is an effective treatment method for laryngeal ACC with excellent LC rates, preservation of the laryngeal function and voice formation, representing a valuable therapy alternative to total laryngectomy.
背景
评估喉腺样囊性癌（ACC）放疗（RT）后的临床结局及喉功能保留情况。
方法
分析11例原发性喉ACC患者，其中5例明确接受了放疗，6例接受了术后放疗，重点关注生存情况及与治疗相关的毒性反应，尤其是喉功能保留情况。
结果
中位随访时间为45个月。放疗的5年局部控制（LC）率高达100%。11例患者中有8例采用了喉保留方法（LPA）。在最后一次随访时，这8例患者中只有1例在治疗11年后出现局部复发，需要行全喉切除术。严重毒性反应并不常见，只有1例采用LPA的患者在治疗期间需要临时气管切开术。
结论
放疗是治疗喉ACC的有效方法，局部控制率高，能保留喉功能及发声功能，是全喉切除术的一种有价值的替代治疗方法。
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