Uno T, Itami J, Kotaka K, Toriyama M
Department of Radiation Therapy and Oncology, International Medical Center of Japan, Tokyo.
Strahlenther Onkol. 1996 Aug;172(8):422-6.
Evaluation of the local control rate and voice preservation probability in radically irradiated patients with T3 laryngeal cancer.
From 1974 through 1992, 37 previously untreated patients with T3 laryngeal cancer (supraglottic 15, glottic 22) were treated with initial radical radiotherapy and surgery for salvage.
Two-year local control rate with radiotherapy alone, ultimate voice preservation rate, and ultimate local control rate for T3 supraglottic cancer were 33%, 33%, and 60%, respectively. Corresponding figures for T3 glottic cancer were 32%, 23%, and 77%, respectively. Five-year cause-specific survival rate for T3 supraglottic cancer and glottic cancer were 47% and 77%, respectively. In T3 supraglottic cancer, none of the 4 patients with subglottic tumor extension attained local control by radiotherapy alone, and local-regional recurrence-free time were significantly shorter in patients with subglottic tumor extension or tracheostomy before radiotherapy. There were no serious late complications such as chondronecrosis, rupture of carotid artery attributed to radical radiotherapy, while 3 patients had severe laryngeal edema requiring total laryngectomy.
Current results indicated that initial radical radiotherapy and surgery for salvage might be an option for some patients with T3 laryngeal cancer.
评估T3期喉癌患者接受根治性放疗后的局部控制率和嗓音保留概率。
1974年至1992年期间，37例未经治疗的T3期喉癌患者（声门上型15例，声门型22例）接受了初始根治性放疗及挽救性手术治疗。
T3期声门上型癌单纯放疗的两年局部控制率、最终嗓音保留率和最终局部控制率分别为33%、33%和60%。T3期声门型癌的相应数据分别为32%、23%和77%。T3期声门上型癌和声门型癌的五年特定病因生存率分别为47%和77%。在T3期声门上型癌中，4例伴有声门下肿瘤侵犯的患者单纯放疗均未实现局部控制，且声门下肿瘤侵犯或放疗前行气管切开术的患者局部区域无复发生存时间明显缩短。根治性放疗未出现软骨坏死、颈动脉破裂等严重晚期并发症，3例患者出现严重喉水肿，需行全喉切除术。
目前的结果表明，初始根治性放疗及挽救性手术可能是部分T3期喉癌患者的一种选择。
