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局部晚期(T-T)喉癌现代管理方法的疗效:一项回顾性队列研究。

Outcomes of the modern management approach for locally advanced (T-T) laryngeal cancer: a retrospective cohort study.

作者信息

Rajgor Amarkumar Dhirajlal, Cowley Josh, Gillespie Colin, Lee Chang Woo, O'Hara James, Iqbal Muhammad Shahid, Hamilton David Winston

机构信息

National Institute for Health & Care Research Doctoral Fellow in Otolaryngology, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.

Department of Otolaryngology - Head and Neck Surgery, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.

出版信息

J Laryngol Otol. 2024 Dec;138(12):1154-1160. doi: 10.1017/S0022215124001105. Epub 2024 Oct 21.

Abstract

BACKGROUND

Our centre (Freeman Hospital, Newcatle Upon Tyne NHS Trust) has favoured primary surgery over chemoradiotherapy for specific advanced laryngeal cancer patients (e.g. large-volume tumours, airway compromise, significant dysphagia, T disease). This study reports the survival outcomes for a modern, high-volume head and neck centre favouring surgical management to determine whether this approach improves survival.

METHOD

Retrospective analysis of patient data over a seven-year period from a tertiary cancer centre.

RESULTS

In total, 121 patients were identified with T ( = 76) or T ( = 45) laryngeal cancer (mean follow up 2.9 years). In the cohort treated with curative intent ( = 104, 86.0 per cent), the 2- and 5-year estimated disease-specific survival rates were 77.9 and 64.1 per cent. chemoradiotherapy had the highest 2-year disease-specific survival (92.5 per cent), followed by surgery with adjuvant therapy (81.8 per cent), radiotherapy alone (75 per cent) and surgery alone (72.4 per cent).

CONCLUSION

For a centre favouring primary surgery for certain advanced laryngeal cancers, the disease-specific survival appears no higher than that found in the published literature. To enhance survival, future research should focus on precision medicine to define treatment pathways in this disease.

摘要

背景

我们中心(泰恩河畔纽卡斯尔国民保健服务信托基金弗里曼医院)对于特定的晚期喉癌患者(例如肿瘤体积大、气道受压、严重吞咽困难、T 分期疾病)更倾向于采用原发手术而非放化疗。本研究报告了一个倾向于手术治疗的现代高容量头颈中心的生存结果,以确定这种方法是否能提高生存率。

方法

对一家三级癌症中心七年期间的患者数据进行回顾性分析。

结果

共确定 121 例 T(n = 76)或 T(n = 45)期喉癌患者(平均随访 2.9 年)。在接受根治性治疗的队列中(n = 104,86.0%),2 年和 5 年的估计疾病特异性生存率分别为 77.9%和 64.1%。放化疗的 2 年疾病特异性生存率最高(92.5%),其次是手术加辅助治疗(81.8%)、单纯放疗(75%)和单纯手术(72.4%)。

结论

对于一个倾向于对某些晚期喉癌进行原发手术的中心,疾病特异性生存率似乎并不高于已发表文献中的生存率。为提高生存率,未来研究应聚焦于精准医学以明确该疾病的治疗途径。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6d5d/11735189/008bd4775ad9/S0022215124001105_fig1.jpg

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