Yates A, Crumley R L
Laryngoscope. 1984 Dec;94(12 Pt 1):1586-90.
Patients with squamous cell carcinoma of the pyriform sinus treated surgically from 1959 through 1979 at the University of California, San Francisco were reviewed. As several reports had previously suggested that the addition of radiation therapy, preoperatively or postoperatively, did not increase survival, our data collection and analysis was performed in such a way as to determine whether similar trends were present in our patients. Data were tabulated for patients having: 1. surgery alone (SA); 2. preoperative radiation and surgery (RS); and 3. surgery and postoperative radiation (SR). The surgery alone group demonstrated the best results, with 65% 3-year determinant survival, and 56% 5-year survival, compared to 50% 3-year and 33% 5-year survivals in the combined groups. In this patient population, the increased death rate in the combined therapy group appeared to be due primarily to a higher distant metastasis rate (50% vs. 26% for the surgery alone group). Although our numbers are too small for any of the comparisons to be significant, the findings of similar cure rates of pyriform sinus cancers by surgery alone support similar data from other authors. As staging was similar in the two groups, and none of the other variables examined appeared to explain these results, we could only conclude that further data is needed, and that the exact role of radiation therapy, in combination with surgery for pyriform sinus cancer remains to be defined.
对1959年至1979年在加利福尼亚大学旧金山分校接受手术治疗的梨状窝鳞状细胞癌患者进行了回顾性研究。由于此前有几份报告表明，术前或术后加用放射治疗并不能提高生存率，因此我们进行数据收集和分析的方式是为了确定我们的患者中是否存在类似趋势。对以下患者的数据进行了列表统计：1. 单纯手术（SA）；2. 术前放疗加手术（RS）；3. 手术加术后放疗（SR）。单纯手术组的结果最佳，3年确定生存率为65%，5年生存率为56%，而联合治疗组的3年生存率为50%，5年生存率为33%。在这个患者群体中，联合治疗组死亡率的增加似乎主要是由于远处转移率较高（单纯手术组为26%，联合治疗组为50%）。尽管我们的病例数过少，无法使任何一项比较具有统计学意义，但单纯手术治疗梨状窝癌的治愈率相似这一发现支持了其他作者的类似数据。由于两组的分期相似，且所检查的其他变量似乎都无法解释这些结果，我们只能得出结论，需要更多数据，且放射治疗与梨状窝癌手术联合的确切作用仍有待确定。
