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[声门癌早期的放射治疗]

[Radiotherapy of carcinoma of the glottis in the initial stage].

作者信息

Neri S, Belli A, Caliceti U, Emiliani E, Frezza G, Palazzi Trivelli A, Silvano M, Zini G, Babini L, Barbieri E

机构信息

Istituto di Radioterapia L. Galvani, Bologna.

出版信息

Radiol Med. 1987 Oct;74(4):338-40.

PMID:3671804
Abstract

The control of early glottic cancer is equally satisfactory with either surgical resection or radiation therapy; this last method gives the patient good functional results. During the period from 1/1978 to 12/1985, 73 patients with early glottic carcinoma (T1 N0 M0) were treated in the Institute of Radiotherapy L. Galvani, University of Bologna; 45 were stage T1a (tumour limited to one vocal cord) and 28 were stage T1b (tumour of both vocal cords or involving anterior commissure); radiation treatment utilised a 60Co machine and 5 x 5 cm fields; the median dose was 67.2 Gy (range 50-76) with conventional fractionation. Ten patients had local recurrence; the median time of recurrence was 13.4 months; 9/10 were treated by surgery and 2/10 died, so the overall control by radiotherapy with surgery in reserve was 100% in T1a tumours and 90.6% in T1b ones. The 5-years disease free survival rate was 93.1% in T1a tumours and 69% in T1b; lesions involving anterior commissure had the worst prognosis, independent of the dose and time-dose factor (3/10 recurrences in the group treated with TDF less than 110 and 4/18 recurrences in the group with TDF more than 110).

摘要

早期声门癌采用手术切除或放射治疗的控制效果同样令人满意;后一种方法能给患者带来良好的功能结果。在1978年1月至1985年12月期间,博洛尼亚大学L. 伽伐尼放射治疗研究所对73例早期声门癌(T1 N0 M0)患者进行了治疗;其中45例为T1a期(肿瘤局限于一侧声带),28例为T1b期(双侧声带肿瘤或累及前联合);放射治疗使用60钴机和5×5厘米的射野;采用常规分割,中位剂量为67.2 Gy(范围50 - 76)。10例患者出现局部复发;复发的中位时间为13.4个月;10例中有9例接受了手术治疗,10例中有2例死亡,因此对于T1a期肿瘤,以手术作为后备的放射治疗总体控制率为100%,T1b期为90.6%。T1a期肿瘤的5年无病生存率为93.1%,T1b期为69%;累及前联合的病变预后最差,与剂量和时间 - 剂量因素无关(时间 - 剂量因子小于110的治疗组中有3/10复发,时间 - 剂量因子大于110的治疗组中有4/18复发)。

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