放疗治疗下咽癌患者的喉咽功能保留：预测因素和长期结果。
Preserving Laryngo-Esophageal Function in Patients With Hypopharyngeal Cancer Treated With Radiotherapy: Predictive Factors and Long-Term Outcomes.
机构信息
Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Department of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
出版信息
Cancer Med. 2024 Nov;13(21):e70374. doi: 10.1002/cam4.70374.
BACKGROUND
Functional outcomes after hypopharyngeal cancer (HPC) treatment have a significant effect on patients' quality of life and prognosis. This study aimed to identify the predictive factors associated with laryngo-esophageal dysfunction in patients with HPC who received definitive radiotherapy.
METHODS
Patients with HPC treated with definitive intensity-modulated radiotherapy between 2007 and 2019 at our institution were retrospectively evaluated. Laryngo-esophageal dysfunction-free survival (LDFS) events were defined as local recurrence, laryngo-esophageal dysfunction (defined as tracheostomy or feeding tube dependence), or death from any cause.
RESULTS
The median follow-up period was 61 months for the 80 patients included in the study. The 5-year LDFS rate was 47%. A clinical T4 stage and lower pretreatment prognostic nutritional index (PNI) were independently associated with a lower LDFS.
CONCLUSION
A clinical T4 stage and lower pretreatment PNI were identified as predictors of a lower LDFS after definitive radiotherapy for HPC.
背景
下咽癌（HPC）治疗后的功能预后对患者的生活质量和预后有重要影响。本研究旨在确定接受根治性调强放疗的 HPC 患者发生喉食管功能障碍的相关预测因素。
方法
回顾性分析了我院 2007 年至 2019 年间接受根治性调强放疗的 HPC 患者。喉食管功能障碍无复发生存（LDFS）事件定义为局部复发、喉食管功能障碍（定义为气管造口或依赖饲管）或任何原因导致的死亡。
结果
纳入的 80 例患者的中位随访时间为 61 个月。5 年 LDFS 率为 47%。临床 T4 期和较低的治疗前预后营养指数（PNI）与较低的 LDFS 独立相关。
结论
临床 T4 期和较低的治疗前 PNI 是 HPC 根治性放疗后较低 LDFS 的预测因素。
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