Laccourreye O, Bassot V, Brasnu D, Jouffre V, Ménard M, Laccourreye H
Service d'Oto-Rhino-Laryngologie et de Chirurgie cervico-faciale, Hôpital Laennec, Université Paris V, Paris.
Presse Med. 1995 Oct 7;24(29):1337-40.
Evaluation of cisplatin-fluorouracil exclusive chemotherapy for invasive squamous cell carcinoma of the glottis staged as T1-T3N0 with a complete response after cisplatin-fluorouracil neo-adjuvant chemotherapy.
A retrospective analysis of the files of 69 patients with a well-differentiated untreated invasive squamous cell carcinoma, staged as T1-T3N0 with a complete response after cisplatin-fluorouracil neo-adjuvant chemotherapy is presented. Actuarial analysis (Kaplan Meier method) of survival and local failure is presented among the group of 25 patients treated with exclusive chemotherapy and the group of 44 patients in whom the local treatment (partial laryngeal surgery or radiation therapy) initially planned was maintained.
Three-year survival and local control estimate was 91.8% and 69.3%, respectively after exclusive chemotherapy and 92.5% and 97.2% if the local treatment was performed as initially planned. Patients with local recurrence after exclusive chemotherapy were always salvaged with partial laryngeal surgery or radiation therapy resulting in an overall 100% local control and laryngeal preservation rate.
Exclusive chemotherapy for T1-T3N0 glottic carcinomas with a complete response after cisplatin-fluorouracil neo-adjuvant chemotherapy should be considered especially in patients in whom preservation of voice is of utmost importance.
评估顺铂-氟尿嘧啶单纯化疗用于声门型浸润性鳞状细胞癌(T1-T3N0期),且在顺铂-氟尿嘧啶新辅助化疗后达到完全缓解的情况。
对69例未接受过治疗的高分化浸润性鳞状细胞癌患者的病历进行回顾性分析,这些患者分期为T1-T3N0,且在顺铂-氟尿嘧啶新辅助化疗后达到完全缓解。对25例接受单纯化疗的患者组和44例维持最初计划的局部治疗(部分喉手术或放射治疗)的患者组进行生存和局部失败的精算分析(Kaplan-Meier法)。
单纯化疗后三年生存率和局部控制率估计分别为91.8%和69.3%,如果按最初计划进行局部治疗,则分别为92.5%和97.2%。单纯化疗后出现局部复发的患者总是通过部分喉手术或放射治疗挽救,从而使总体局部控制率和喉保留率达到100%。
对于T1-T3N0声门癌,在顺铂-氟尿嘧啶新辅助化疗后达到完全缓解的患者,应考虑单纯化疗,尤其是对于声音保留至关重要的患者。