Kanonier G, Fritsch E, Rainer T, Thumfart W F
Department of Otolaryngology, University of Innsbruck, Austria.
Ann Otol Rhinol Laryngol. 1996 Oct;105(10):759-63. doi: 10.1177/000348949610501001.
Radiotherapy is widely accepted as primary treatment in the T1 stage of glottic cancer, but controversy surrounds the proper approach to T2 lesions of the glottis. A retrospective review of 90 patients addresses treatment results for T1 and T2 lesions of glottic carcinoma managed by primary radiotherapy with 60 to 64 Gy from 1977 to 1989. Seventy-nine patients met the criteria for local control analysis with a minimum follow-up of 5 years. Radiotherapy alone controlled disease in 93% (43 of 46) of patients with T1 lesion and 18% (6 of 33) of those with T2 tumors (including 10 patients in whom radiotherapy was terminated at 40 Gy because of persistent tumor). Ultimate control of disease for T1 and T2 lesions, including surgical salvage, was 100% and 82%, respectively. Larynx preservation was achieved in 100% of T1 and in 45% of T2 lesions. Extension of tumor and impaired vocal cord mobility showed statistical significance for adverse prognosis (p < .001). This paper discusses how these results affect treatment of glottic carcinoma, particularly in the T2 stage.
放射治疗被广泛认为是声门癌T1期的主要治疗方法，但对于声门T2期病变的恰当治疗方法仍存在争议。一项对90例患者的回顾性研究探讨了1977年至1989年期间采用60至64 Gy的原发性放射治疗的声门癌T1和T2期病变的治疗结果。79例患者符合局部控制分析标准，随访至少5年。单纯放射治疗使93%（46例中的43例）的T1期患者和18%（33例中的6例）的T2期肿瘤患者（包括10例因肿瘤持续存在于40 Gy时终止放射治疗的患者）疾病得到控制。T1和T2期病变包括手术挽救在内的最终疾病控制率分别为100%和82%。100%的T1期病变和45%的T2期病变实现了喉保留。肿瘤扩展和声带活动受限对不良预后具有统计学意义（p < .001）。本文讨论了这些结果如何影响声门癌的治疗，尤其是在T2期。
