经口激光显微手术与放射治疗用于治疗累及前联合的T1-T2声门癌：一项系统评价和Meta分析
Transoral Laser Microsurgery Versus Radiotherapy for T1-T2 Glottic Cancer with Anterior Commissure Involvement: A Systematic Review and Meta-Analysis.
作者信息
Vasudevan Srivatsa Surya, Bryan Elizabeth, Ericksen Elise, Alla Anika, Asarkar Ameya A, Olinde Lindsay, Katz Sanford, Nathan Cherie-Ann O
机构信息
Department of Otolaryngology-Head and Neck Surgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana, U.S.A.
Louisiana State University Health School of Medicine, Shreveport, Louisiana, U.S.A.
出版信息
Laryngoscope. 2025 Jun;135(6):1861-1871. doi: 10.1002/lary.32005. Epub 2025 Jan 11.
OBJECTIVE
To identify the most effective treatment modality for achieving favorable outcomes in early glottic tumors with anterior commissure involvement (ACI).
DATA SOURCES
PubMed, Embase, Web of Science, and ScienceDirect.
REVIEW METHODS
Random-effects proportional meta-analysis model is used to evaluate the oncological and functional outcomes of transoral laser microsurgery (TLM) versus radiation therapy (RT) in early glottic (T1-T2) cancer with ACI.
RESULTS
From a total of 736 studies, 40 studies were included, comprising 2666 early glottic tumor patients with ACI. TLM (52%) and upfront RT (48%) were the primary treatment groups. TLM had better 5-year overall survival (OS) (84.5% [80.3%-88.0%] vs. 79.4% [75.7%-82.7%]). Similarly, TLM-treated patients had better 3-year pooled disease-free survival (DFS) compared with RT-treated patients (82.7% [77.1%-87.1%] vs. 73.3% [23.8%-96.0%]). TLM exhibited a better 5-year local control rate (LCR) than RT (77.2% vs. 71.6%). In our temporal analysis, TLM had a higher 5-year LCR than RT (78.2% vs. 63.5%) in 2001-2012, with similar rates in 2013-2024 (76.8% vs. 78.4%). TLM-treated patients had higher laryngeal preservation rates compared with RT patients (93% [90.6%-94.8%] vs. 87.6% [82.8%-91.2%]).
CONCLUSIONS
Our meta-analysis is the first in the literature to compare the outcomes between TLM and RT-treated patients with ACI in early glottic tumors. TLM-treated patients appear to have superior 5-year OS and laryngeal preservation compared with upfront RT-treated patients. However, both TLM and RT exhibited comparable oncological outcomes in early glottic tumor patients with ACI during the recent period from 2013 to 2024. Laryngoscope, 135:1861-1871, 2025.
目的
确定对早期累及前联合（ACI）的声门肿瘤取得良好疗效的最有效治疗方式。
数据来源
PubMed、Embase、Web of Science和ScienceDirect。
综述方法
采用随机效应比例荟萃分析模型，评估经口激光显微手术（TLM）与放射治疗（RT）在伴有ACI的早期声门（T1-T2）癌中的肿瘤学和功能结局。
结果
在总共736项研究中，纳入了40项研究，包括2666例伴有ACI的早期声门肿瘤患者。TLM组（52%）和初始RT组（48%）为主要治疗组。TLM的5年总生存率（OS）更高（84.5% [80.3%-88.0%] 对比79.4% [75.7%-82.7%]）。同样，与接受RT治疗的患者相比，接受TLM治疗的患者3年汇总无病生存率（DFS）更高（82.7% [77.1%-87.1%] 对比73.3% [23.8%-96.0%]）。TLM的5年局部控制率（LCR）优于RT（77.2%对比71.6%）。在我们的时间分析中，2001 - 2012年TLM的5年LCR高于RT（78.2%对比63.5%），2013 - 2024年两者比例相似（76.8%对比78.4%）。与RT患者相比，接受TLM治疗的患者喉保留率更高（93% [90.6%-94.8%] 对比87.6% [82.8%-91.2%]）。
结论
我们的荟萃分析是文献中首次比较TLM与RT治疗伴有ACI的早期声门肿瘤患者的结局。与初始接受RT治疗的患者相比，接受TLM治疗的患者5年OS和喉保留情况似乎更优。然而，在2013年至2024年最近期间，TLM和RT在伴有ACI的早期声门肿瘤患者中显示出相当的肿瘤学结局。《喉镜》，135:1861 - 1871，2025年。
Zotero 插件