Fein D A, Lee W R, Hanlon A L, Ridge J A, Curran W J, Coia L R
Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA 19111, USA.
Int J Radiat Oncol Biol Phys. 1996 Mar 1;34(4):823-31. doi: 10.1016/0360-3016(95)02205-8.
To evaluate treatment and patient related prognostic factors that may influence local control in the treatment of T1-T2 squamous cell carcinoma of the glottic larynx.
One hundred nine patients with invasive, previously untreated T1-T2 squamous cell carcinoma of the glottic larynx were treated with curative intent with radiotherapy at the Fox Chase Cancer Center between June 1980 and November 1991. Follow-up ranged from 26-165 months (mean 83 months).
The 2-year local control rates for patients with T1 and T2 lesions were 89% and 80%, respectively. The 2-year local control rate for patients whose overall treatment time was < 50 days was 92% vs. 82% for patients whose overall treatment time was > 50 days (p = 0.07). The 2-year local control rate for patients treated with an irradiated area < 36 cm(2) was 90% compared to 86% in patients who were treated to an area > or = 36 cm(2). The 2-year local control rate for patients treated with 60Co was 83% vs. 92% for patients treated with 6 MV x-ray. Cox proportional hazards regression analysis was performed using the following variables: treatment energy, irradiated area, gender, tobacco pack years, tumor differentiation, overall treatment time, total dose, dose per fraction, and T stage. Overall treatment time (p = 0.05) was the only variable that significantly influenced local control.
Extending the overall treatment time was found to adversely influence local control. Neither the irradiated area nor treatment energy was found to influence local control in early stage vocal cord carcinoma.
评估可能影响声门型喉T1-T2期鳞状细胞癌局部控制的治疗及患者相关预后因素。
1980年6月至1991年11月期间，109例声门型喉浸润性、未经治疗的T1-T2期鳞状细胞癌患者在福克斯蔡斯癌症中心接受了根治性放疗。随访时间为26-165个月（平均83个月）。
T1和T2期病变患者的2年局部控制率分别为89%和80%。总治疗时间<50天的患者2年局部控制率为92%，而总治疗时间>50天的患者为82%（p = 0.07）。照射面积<36 cm²的患者2年局部控制率为90%，而照射面积≥36 cm²的患者为86%。接受60Co治疗的患者2年局部控制率为83%，而接受6 MV X线治疗的患者为92%。使用以下变量进行Cox比例风险回归分析：治疗能量、照射面积、性别、吸烟包年数、肿瘤分化程度、总治疗时间、总剂量、分次剂量和T分期。总治疗时间（p = 0.05）是唯一显著影响局部控制的变量。
发现延长总治疗时间会对局部控制产生不利影响。在早期声带癌中，未发现照射面积和治疗能量会影响局部控制。
