Van den Bogaert W, Ostyn F, Lemkens P, van der Schueren E
Radiother Oncol. 1984 Jun;2(1):31-6. doi: 10.1016/s0167-8140(84)80035-3.
In order to improve local cure rates and survival in patients with head and neck cancer, combinations of radiotherapy and surgery are used. Most reports on such treatment results indicate an improvement with combined therapy. However, it is not clear whether it is best to irradiate before or after surgery. There is disagreement in the literature, whether postoperative complications are more frequent when the irradiation is given prior to surgery. The incidence of postoperative complications was studied in 213 patients who had a laryngectomy for laryngeal or hypopharyngeal cancer. The incidence of major complications was 8.5% after a preoperative dose of 40 or 50 Gy. After rescue surgery for radiation failure this percentage was 32%. In our experience, the incidence of postoperative complications after doses up to 50 Gy/5 weeks is comparable to what can be expected after surgery alone. When higher doses are given, these complications are more frequent. In designing treatment plans, such considerations should be kept in mind.
为了提高头颈癌患者的局部治愈率和生存率，放疗和手术联合使用。大多数关于此类治疗结果的报告表明联合治疗有改善。然而，尚不清楚术前还是术后放疗效果最佳。文献中存在分歧，即术前放疗时术后并发症是否更常见。对213例行喉切除术治疗喉癌或下咽癌的患者术后并发症发生率进行了研究。术前给予40或50 Gy剂量后，主要并发症发生率为8.5%。放疗失败后行挽救性手术后，这一比例为32%。根据我们的经验，5周内给予剂量达50 Gy后的术后并发症发生率与单纯手术后的预期发生率相当。当给予更高剂量时，这些并发症更常见。在设计治疗方案时，应牢记这些因素。
