Caliceti U, Frezza G, Galuppi A, Guidetti A, Pasquini E, Sorrenti G, Cavicchi O, Rinaldi Ceroni A
Istituto di Clinica ORL, L. Galvani.
Acta Otorhinolaryngol Ital. 1996 Feb;16(1):35-9.
The Authors reviewed a group of 28 pts with early-stage supraglottic carcinoma (T1-T2N0), classified according to UICC (1987), and treated exclusively with radiotherapy (RT) between 1980 and 1991. Until 1990 RT was employed for such tumors when surgery was refused or controindicated, while since 1991 primary irradiation (with surgery in reserve) has been considered the treatment of choice. The total dose ranged from 66 to 70 Gy on the larynx and up to 50 Gy on neck nodes. RT was applied in a daily fraction of 2 Gy five times a week. No significant early complications were observed. Only 1 pt showed residual cronical oedema in the arytenoid region. In none of the pts was tracheostomy necessary. The local control rate obtained after 30 months was 85.7% (24/28). Salvage surgery (horizontal supraglottic laringectomy, HSL) was performed in 3 out of 4 pts with local failure and achieved complete control of the disease. In the last pt the surgery was controindicated because of poor general health conditions. The actuarial survival rate after 5 years is 86.2%. The present series was compared to a group of 152 pts with T1-T2N0 supraglottic cancer treated surgically (HSL) at the same Istitution. In these pts local control and the actuarial survival rates are 85.6% and 89% respectively. According to recent Literature data, the present findings confirm that RT may be administered for the treatment of selected early stage (T1-T2N0) supraglottic squamous cell carcinoma of the larynx with oncologic results equivalent to those obtained with radical surgery. The importance of imaging techniques (TC, MRI) in the correct staging of the tumor is emphasised.
作者回顾了一组28例早期声门上癌（T1 - T2N0）患者，这些患者根据国际抗癌联盟（UICC，1987年）进行分类，于1980年至1991年间仅接受放射治疗（RT）。直到1990年，当手术被拒绝或有禁忌时，RT才用于此类肿瘤，而自1991年以来，原发性放疗（保留手术作为备用）被视为首选治疗方法。喉部的总剂量范围为66至70 Gy，颈部淋巴结的总剂量高达50 Gy。RT以每周五次、每次2 Gy的剂量进行。未观察到明显的早期并发症。只有1例患者在杓状软骨区域出现残留的慢性水肿。所有患者均无需气管切开术。30个月后的局部控制率为85.7%（24/28）。4例局部失败患者中有3例接受了挽救性手术（水平声门上喉切除术，HSL），并实现了疾病的完全控制。最后1例患者因全身健康状况不佳而手术禁忌。5年的精算生存率为86.2%。将本系列与同一机构手术治疗（HSL）的152例T1 - T2N0声门上癌患者进行比较。在这些患者中，局部控制率和精算生存率分别为85.6%和89%。根据最近的文献数据，目前的研究结果证实，RT可用于治疗部分早期（T1 - T2N0）喉声门上鳞状细胞癌，其肿瘤学结果与根治性手术相当。强调了成像技术（CT、MRI）在肿瘤正确分期中的重要性。
