Spaulding C A, Gillenwater A, Constable W C, Hahn S S, Kersh C R
Division of Radiation Oncology, University of Virginia Medical Center, Charlottesville 22908.
Laryngoscope. 1987 Dec;97(12):1450-3. doi: 10.1288/00005537-198712000-00013.
Vocal cord fixation in supraglottic and pyriform sinus cancers has, in the past, precluded management by radiotherapy alone. Ninety-eight patients were reviewed to determine the prognostic effect of vocal cord fixation. The predictive value of cord mobility status after 50 Gy was evaluated with respect to treatment modality. For patients treated with radiotherapy alone, cord mobility status was predictive of recurrence, yielding 3 year recurrence rates of 33.3% (mobile) versus 80% (fixed) [p = 0.04]. Mobile cords after 50 Gy had similar recurrence rates (33.3% vs. 40.0%, p = 0.60) whether treated by radiotherapy or radiotherapy/surgery. Radiotherapy alone may be used in cases when fixed cords become mobile after 50 Gy without compromising cure rates or laryngeal function. Combined modality provides the best results when cords remain fixed.
过去，声门上癌和梨状窦癌中的声带固定使得无法仅通过放疗进行治疗。对98例患者进行了回顾，以确定声带固定的预后影响。针对治疗方式评估了50 Gy后声带活动状态的预测价值。对于仅接受放疗的患者，声带活动状态可预测复发情况，3年复发率在活动声带患者中为33.3%，而固定声带患者为80%[p = 0.04]。50 Gy后声带活动的患者，无论接受放疗还是放疗/手术，复发率相似（33.3%对40.0%，p = 0.60）。当固定声带在50 Gy后变为活动状态时，仅放疗可用于此类病例，且不影响治愈率或喉功能。当声带保持固定时，综合治疗方式效果最佳。
