Düring A, Sauer R, Steiner W, Herbst M, Reul H
Strahlentherapeutische Klinik und Poliklinik, Universität Erlangen-Nürnberg.
Strahlenther Onkol. 1987 Dec;163(12):764-73.
From 1978 through 1984, 120 patients with hypopharyngeal carcinomas were treated cooperatively by the University Hospitals of Erlangen. 120 out of these patients were men and 6 women. 96 patients (80%) suffered from cervical lymph node metastases, 91 (76%) were already in UICC stage IV. There were two cases with stage I, eight cases (7%) with stage II, and 19 cases (16%) with stage III. Among the 116 patients treated by causal therapy, 70 (60%) reached complete remission (CR), 34 (29.5%) partial remission (PR), and 12 (10.5%) were non-responders (NC,P). The cumulative survival at five years was 14% in 120 patients and 24% in 70 patients after CR. None of the patients with PR or NC survived more than two years. 111 patients were irradiated. Group 1: radiotherapy alone (41 patients), group 2: surgery and radiotherapy (47 patients), group 3: chemotherapy and radiotherapy (19 patients). The medium treatment period was 76, 107, and 141 days, respectively. The cumulative survival at five years was 3% in group 1, 28% in group 2, the survival at three years in group 3 was 14%. The results of postoperative radiotherapy, amounting to 36%, were better than the rate of 20% achieved by preoperative radiotherapy and surgery. A survival at five years of 46% was obtained after transoral microlaryngoscopic laser resection and postoperative irradiation, which was therefore superior to conventional operation techniques combined with radiotherapy (16%). Moreover, better functional and cosmetic results were achieved with this method. The prognosis is unfavorably influenced by a high stage, lymph node manifestations, and dedifferentiated tumor histology.
1978年至1984年期间，埃尔朗根大学医院联合治疗了120例下咽癌患者。其中男性120例，女性6例。96例患者（80%）有颈部淋巴结转移，91例（76%）已处于国际抗癌联盟（UICC）IV期。I期2例，II期8例（7%），III期19例（16%）。在116例接受病因治疗的患者中，70例（60%）达到完全缓解（CR），34例（29.5%）部分缓解（PR），12例（10.5%）无反应（NC，P）。120例患者的五年累积生存率为14%，CR后70例患者的五年累积生存率为24%。PR或NC患者均无存活超过两年的。111例患者接受了放疗。第1组：单纯放疗（41例），第2组：手术加放疗（47例），第3组：化疗加放疗（19例）。平均治疗期分别为76天、107天和141天。第1组的五年累积生存率为3%，第2组为28%，第3组的三年生存率为14%。术后放疗的结果为36%，优于术前放疗和手术的20%。经口显微喉镜激光切除及术后放疗后五年生存率为46%，因此优于传统手术技术联合放疗（16%）。而且，用这种方法获得了更好的功能和美容效果。高分期、淋巴结表现和肿瘤组织学低分化对预后有不利影响。
