Carpenter R J, DeSanto L W, Devine K D, Taylor W F
Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minn. 55901.
Arch Otolaryngol. 1976 Dec;102(12):716-21. doi: 10.1001/archotol.1976.00780170034002.
Between 1962 and 1972, 190 patients with squamous cell carcinoma of the hypopharynx were seen; 162 received primary treatment at our clinic. Of the 162 lesions, 117 (72%) originated in the pyriform sinus. The most frequent symptom was pain in the throat (87 patients, 54%). One hundred twenty six patients (78%) had tumors extending beyond the hypopharynx (T3 lesions), and 108 patients (67%) had cervical metastasis (stage III or IV). Treatment modalities included surgical excision in 82 patients, radiation in 39, planned combination of preoperative radiation followed by surgery in 18, radiation plus neck dissection in 15, and surgery plus postoperative radiation in eight. Sixty-nine patients (43%) had recurrent tumor. Recurrences were equally frequent in the primary site and the neck. Comparison of treatment modalities showed no differences in overall recurrence. Surgery alone or in combination with radiation reduced the incidence of local recurrence; however, when recurrences were analyzed in relation to stage of lesion, preoperative or postoperative radiation and surgery offered no advantage over surgery alone in reducing local or neck recurrence or in overall survival rate. Treatment by radiation alone was associated with a poorer survival. For the entire group, three-year survival was 52% and five-year survival was 47%.
1962年至1972年间，共诊治190例下咽鳞状细胞癌患者；162例在我院接受了初始治疗。在这162处病损中，117例（72%）起源于梨状窝。最常见的症状是咽痛（87例，54%）。126例患者（78%）的肿瘤已超出下咽范围（T3期病损），108例患者（67%）有颈部转移（Ⅲ期或Ⅳ期）。治疗方式包括82例行手术切除，39例行放疗，18例行术前放疗后再手术的计划性联合治疗，15例行放疗加颈部清扫术，8例行手术加术后放疗。69例患者（43%）出现肿瘤复发。原发部位和颈部的复发频率相同。治疗方式的比较显示总体复发率无差异。单纯手术或手术联合放疗可降低局部复发率；然而，当根据病损分期分析复发情况时，术前或术后放疗及手术在降低局部或颈部复发率或总体生存率方面并不比单纯手术更具优势。单纯放疗的患者生存率较低。整个组的三年生存率为52%，五年生存率为47%。
