Mendenhall William M, Morris Christopher G, Amdur Robert J, Hitchcock Kathryn E, Chheda Neil, Dziegielewski Peter T
Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, Florida, USA.
Department of Otolaryngology, University of Florida College of Medicine, Gainesville, Florida, USA.
Head Neck. 2020 Dec;42(12):3515-3517. doi: 10.1002/hed.26411. Epub 2020 Aug 17.
The aim of the study was to update our experience treating patients with glottic carcinoma in situ (CIS) with curative radiotherapy (RT).
Fifty patients received continuous-course RT using once-daily fractionation. Twenty-eight (56%) had recurrent or persistent CIS after resection. Median total dose was 63.0 Gy; median dose per fraction was 2.25 Gy. Median follow-up was 9.6 years for all patients and 8.4 years for survivors.
After RT, 5 patients (10%) recurred locally; salvage surgery was performed in 4 (1 refused). Five-year outcomes were as follows: local control, 91%; ultimate local control (including patients successfully salvaged after local recurrence), 100%; ultimate local control with larynx preservation, 93%; local-regional control, 91%; ultimate local-regional control, 100%; distant metastases-free survival, 100%; cause-specific survival, 100%; and overall survival, 81%. No patient experienced a severe complication.
RT is an excellent treatment for patients with CIS recurrent after transoral excision and those with previously untreated CIS who are unsuitable for partial laryngectomy.
本研究的目的是更新我们采用根治性放射治疗（RT）治疗原位声门癌（CIS）患者的经验。
50例患者接受了每日一次分割的连续疗程RT。28例（56%）在切除术后出现复发或持续性CIS。总剂量中位数为63.0 Gy；每次分割剂量中位数为2.25 Gy。所有患者的中位随访时间为9.6年，幸存者的中位随访时间为8.4年。
RT后，5例患者（10%）出现局部复发；4例（1例拒绝）接受了挽救性手术。5年结果如下：局部控制率为91%；最终局部控制率（包括局部复发后成功挽救的患者）为100%；保留喉的最终局部控制率为93%；局部区域控制率为91%；最终局部区域控制率为100%；无远处转移生存率为100%；病因特异性生存率为100%；总生存率为81%。没有患者出现严重并发症。
对于经口切除术后复发的CIS患者以及不适合行部分喉切除术的未经治疗的CIS患者，RT是一种极佳的治疗方法。
