Eisbach K J, Krause C J
Laryngoscope. 1977 Nov;87(11):1904-10. doi: 10.1002/lary.1977.87.11.1904.
One hundred four patients with epidermoid carcinoma of the pyriform fossa were reviewed retrospectively. Survival, local recurrence and metastatic rates were all compiled for the purpose of comparing the efficacy of combined therapy with radiation therapy and surgery alone in treating such lesions. Combined therapy consisted of 4500 rad Cobalt60 therapy at 200 rad per day preoperatively. All lesions were staged according to AJC classification. There was a similar stage distribution of patients in each therapeutic category. Three-year determinate survival rates were as follows: radiation therapy --10%, surgery--56%, and combined therapy--40%. Evaluation of the local recurrence rate revealed it to be: radiation therapy--19/33 (58%), surgery--1/19 (5%), and combined therapy--9/32 (28%). We interpret this data to suggest that preoperative irradiation impaired the determination of adequate resection margins, despite the use of frozen sections from those margins at the time of surgery. The incidence of late contralateral palpable nodes was greatest in the surgery group--5/19 (26%), compared with radiation therapy--0/33, and combined therapy--1/32 (3%). This supports other studies which indicate that radiation therapy is very effective in controlling subclinical nodal metastases.
对104例梨状窝表皮样癌患者进行了回顾性研究。为比较联合治疗与单纯放疗和手术治疗此类病变的疗效，统计了生存率、局部复发率和转移率。联合治疗包括术前每天200拉德的4500拉德钴60治疗。所有病变均根据AJC分类进行分期。各治疗组患者的分期分布相似。三年确定生存率如下：放疗组为10%，手术组为56%，联合治疗组为40%。局部复发率评估结果显示：放疗组为19/33（58%），手术组为1/19（5%），联合治疗组为9/32（28%）。我们对这些数据的解读表明，尽管手术时对切缘进行了冰冻切片检查，但术前放疗仍会影响对足够切缘的判定。手术组晚期对侧可触及淋巴结的发生率最高，为5/19（26%），而放疗组为0/33，联合治疗组为1/32（3%）。这支持了其他研究，表明放疗在控制亚临床淋巴结转移方面非常有效。
