Alvarez Vicent J J, Brandariz Castelo J A, Domingo Carrasco C, Mendiola C, Guerrero J, Cornejo M
Hospital Universitario 12 de Octubre, Madrid.
An Otorrinolaringol Ibero Am. 1995;22(2):179-96.
Since 1980 we use adjuvant chemotherapy in advanced laryngopharyngeal carcinomas. These cases were resectable and unresectable lesions with tumoral extent to the pharynx as a common characteristic. We analyze the survival of the first 50 cases treated with chemotherapy followed by: A) surgery and radiotherapy (36 cases) and B) radiotherapy alone (14 cases). Results of this not randomized study are compared with a historic group of advanced laryngopharyngeal carcinomas (T4/N+) treated with conventional therapy (surgery +/- radiotherapy). Response to chemotherapy was complete or partial (> 50% reduction) in 56 percent of the patients. There was improvement in overall survival and five-years disease-free survival in the latter group compared with those who did show any response (p < 0.01). We would point out that disease-free survival of the group A was better than historic group (60% vs 36%, p < 0.05), although these result should be carefully interpreted. Laryngeal preservation was achieved in 47 percent in the group A by modification of the initially scheduled radical surgery, in selected cases.
自1980年以来，我们在晚期喉咽癌中使用辅助化疗。这些病例包括可切除和不可切除的病变，其共同特征是肿瘤侵犯至咽部。我们分析了首批接受化疗的50例患者的生存情况，后续治疗方案为：A）手术加放疗（36例）和B）单纯放疗（14例）。将这项非随机研究的结果与一组采用传统治疗（手术±放疗）的晚期喉咽癌（T4/N+）历史病例进行比较。56%的患者对化疗有完全或部分反应（肿瘤缩小>50%）。与无反应的患者相比，后一组患者的总生存率和五年无病生存率有所提高（p<0.01）。我们指出，A组的无病生存率优于历史病例组（60%对36%，p<0.05），尽管这些结果应谨慎解读。在A组中，通过对选定病例最初计划的根治性手术进行改良，47%的患者实现了喉功能保留。
