Li Ruichen, Wang Qi, Yan Li, Zhu Yi, Wang Shengzi, Tian Shu
Department of Radiation Oncology, Eye, Ear, Nose & Throat Hospital of Fudan University, Shanghai 200031, China.
Department of Vascular Surgery, Huashan Hospital of Fudan University, Shanghai 200031, China.
Oral Oncol. 2021 May;116:105230. doi: 10.1016/j.oraloncology.2021.105230. Epub 2021 Feb 26.
The study was intended to compare the outcomes for T1-T2N0M0 glottic squamous cell carcinoma with anterior commissure involvement who had undergone partial laryngectomy (PL) or radiotherapy (RT).
We retrospectively analyzed 256 patients who were treated by RT (n = 70) or PL (n = 186). Patients received prophylactic irradiation of the neck in RT group whereas PL was not associated with lymphadenectomy. Propensity score matching (PSM) was used to eliminate the baseline variations.
The average age of the RT group (67 years) was significantly higher than that of the PL (59 years). Local recurrence was noted in 14 patients of the RT group and 22 of the PL. While regional recurrence was noted in only 1 patient of the RT group and 23 of the PL. After PSM, the 5-year overall survival (82.8% vs. 83.9%, p = 0.302), 5-year cancer-specific survival (88.3% vs. 89.7%, p = 0.793), 5-year local relapse-free survival (79.3% vs. 84.5%, p = 0.127) were not significantly different between two groups. However, 5-year regional relapse-free survival in the RT group was significantly better than that in the PL (100% vs. 87.1%, p = 0.014). In the PL group, infection, granuloma, laryngeal stenosis, chylous leakage, and pharyngeal fistula were reported in six, 11, 12, one, and two patients, respectively.
RT resulted in comparable rates of survival, local control, and larynx preservation compared to PL. However, RT was associated with higher regional control rate. The complication rates were extremely low in RT group.
本研究旨在比较接受部分喉切除术（PL）或放射治疗（RT）的伴有前联合受累的T1-T2N0M0声门鳞状细胞癌的治疗结果。
我们回顾性分析了256例接受RT（n = 70）或PL（n = 186）治疗的患者。RT组患者接受颈部预防性照射，而PL不涉及淋巴结清扫。采用倾向评分匹配（PSM）来消除基线差异。
RT组的平均年龄（67岁）显著高于PL组（59岁）。RT组有14例患者出现局部复发，PL组有22例。而RT组仅1例患者出现区域复发，PL组有23例。PSM后，两组的5年总生存率（82.8%对83.9%，p = 0.302）、5年癌症特异性生存率（88.3%对89.7%，p = 0.793）、5年局部无复发生存率（79.3%对84.5%，p = 0.127）无显著差异。然而，RT组的5年区域无复发生存率显著优于PL组（100%对87.1%，p = 0.014）。在PL组中，分别有6例、11例、12例、1例和2例患者报告出现感染、肉芽肿、喉狭窄、乳糜漏和咽瘘。
与PL相比，RT在生存率、局部控制和喉保留率方面相当。然而，RT的区域控制率更高。RT组的并发症发生率极低。
