Mukherji S K, Mancuso A A, Mendenhall W, Kotzur I M, Kubilis P
Department of Radiology, University of Florida College of Medicine, Shands, Teaching Hospital, Gainesville, USA.
AJNR Am J Neuroradiol. 1995 Apr;16(4):655-62.
To determine whether pretreatment CT can predict local control of T2 squamous cell carcinoma of the glottic larynx treated with radiation therapy alone.
Pretreatment CT studies were retrospectively evaluated by two head and neck radiologists in 28 patients with T2 squamous cell carcinoma of the glottic larynx treated with definitive radiation therapy. All patients were followed for a minimum of 2 years. A tumor score was calculated based on the CT findings of tumor involvement of the following areas: the anterior commissure, the contralateral true vocal cord, the arytenoid face, the interarytenoid region, the laryngeal ventricle, the paraglottic space at the true and false vocal cord levels, and the subglottic region. Tumor volumes based on pretreatment CT were measured in each patient using a computer digitizer. Statistical analysis was performed using the independent sample t test, Wilcoxon's rank sum test, and Fisher's Exact Test.
There was no statistically significant relationship between tumor volume or tumor score and outcome of the T2 glottic tumors treated with definitive radiation therapy in this series. The overall local control rate was 82%. There were no treatment complications that resulted in loss of laryngeal function.
Like low-volume supraglottic and T3 glottic carcinomas, T2 glottic squamous cell carcinoma is likely (82%) to be controlled with definitive radiation therapy. Failure to control the primary tumor is attributable to factors other than volume, which may not be detectable on CT, such as tumor-host biological factors. Pretreatment CT, however, is beneficial for detecting submucosal spread across the ventricle and subglottic extension, which might contraindicate vertical hemilaryngectomy and might not be apparent on endoscopic examination.
确定治疗前CT能否预测单纯放疗的声门型T2期鳞状细胞癌的局部控制情况。
两名头颈放射科医生对28例接受根治性放疗的声门型T2期鳞状细胞癌患者的治疗前CT研究进行回顾性评估。所有患者均随访至少2年。根据肿瘤累及以下区域的CT表现计算肿瘤评分：前联合、对侧真声带、杓状软骨面、杓间区、喉室、真假声带水平的声门旁间隙以及声门下区。使用计算机数字化仪测量每位患者基于治疗前CT的肿瘤体积。采用独立样本t检验、Wilcoxon秩和检验和Fisher精确检验进行统计分析。
在本系列中，接受根治性放疗的T2期声门肿瘤的肿瘤体积或肿瘤评分与预后之间无统计学显著关系。总体局部控制率为82%。没有导致喉功能丧失的治疗并发症。
与小体积声门上型和声门型T3期癌一样，声门型T2期鳞状细胞癌很可能（82%）通过根治性放疗得到控制。原发肿瘤未能得到控制归因于体积以外的因素，这些因素在CT上可能无法检测到，如肿瘤-宿主生物学因素。然而，治疗前CT有助于检测跨喉室的黏膜下扩散和声门下延伸，这可能是垂直半喉切除术的禁忌证，且在内镜检查中可能不明显。
