下咽癌经口激光显微手术的系统评价与荟萃分析
Systematic review and meta-analysis of transoral laser microsurgery in hypopharyngeal carcinoma.
作者信息
Lane Ciaran, Rabbani Rasheda, Linton Janice, Taylor S Mark, Viallet Norbert
机构信息
Department of Otolaryngology - Head and Neck Surgery University of Manitoba Winnipeg Canada.
George & Fay Yee Center for Healthcare Innovation, Max Rady College of Medicine, Rady Faculty of Health Sciences University of Manitoba Winnipeg Manitoba Canada.
出版信息
Laryngoscope Investig Otolaryngol. 2020 Jan 14;5(1):66-73. doi: 10.1002/lio2.351. eCollection 2020 Feb.
BACKGROUND
Transoral laser microsurgery has been suggested as an alternative treatment modality for hypopharyngeal carcinoma. The purpose of this study is to systematically review the oncologic and functional outcomes of patients with hypopharyngeal carcinoma when treated with primary transoral laser microsurgery.
METHODS
A comprehensive literature search was performed using PRISMA methodology on OVID MEDLINE and EMBASE. Meta-analysis was completed for oncological outcomes.
RESULTS
Six studies reported quality of life outcomes five reported oncologic outcomes. A median of 95% (range 0.83-0.98) patients achieving gastrostomy independence, a median of 3% (range 0%-6%) were tracheostomy dependent, and a median of 97% (Range 0.89-1.0) were able to preserve their larynx. Pooled five-year overall survival was 54% (CI, 0.50-0.58, I = 29%), pooled disease-specific survival was 72% (CI, 0.68-0.77, I = 46%), and pooled local control rate was 78% (CI, 0.72-0.85, I = 69%).
CONCLUSION
Systematic review supports improvements in functional outcomes and oncologic outcomes with transoral laser microsurgery.
背景
经口激光显微手术已被提议作为下咽癌的一种替代治疗方式。本研究的目的是系统评价原发性经口激光显微手术治疗下咽癌患者的肿瘤学和功能结局。
方法
采用PRISMA方法在OVID MEDLINE和EMBASE上进行全面的文献检索。对肿瘤学结局进行荟萃分析。
结果
六项研究报告了生活质量结局，五项报告了肿瘤学结局。中位95%（范围0.83 - 0.98）的患者实现了胃造口独立，中位3%（范围0% - 6%）的患者依赖气管造口，中位97%（范围0.89 - 1.0）的患者能够保留喉。汇总的五年总生存率为54%（CI，0.50 - 0.58，I = 29%），汇总的疾病特异性生存率为72%（CI，0.68 - 0.77，I = 46%），汇总的局部控制率为78%（CI，0.72 - 0.85，I = 69%）。
结论
系统评价支持经口激光显微手术在功能结局和肿瘤学结局方面的改善。
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