Mendenhall W M, Parsons J T, Mancuso A A, Pameijer F J, Stringer S P, Cassisi N J
Department of Radiation Oncology, University of Florida College of Medicine, Gainesville 32610-0385, USA.
J Clin Oncol. 1997 Jun;15(6):2394-402. doi: 10.1200/JCO.1997.15.6.2394.
To report the results of radiotherapy alone for stage T3 squamous cell carcinoma of the true vocal cord and compare these data with those obtained with other treatment modalities.
Seventy-five patients with previously untreated T3 squamous cell carcinoma of the glottic larynx were treated with curative intent with radiotherapy alone (73 patients) or followed by a planned neck dissection (two patients) at the University of Florida between September 1966 and August 1994. No patient received adjuvant chemotherapy. All patients were monitored for at least 2 years and 85% had a minimum follow-up duration of 5 years. No patient was lost to follow-up evaluation.
The 5-year local control and ultimate local control rates were 63% and 86%, respectively. The volume of the primary tumor (which was calculated on pretreatment computed tomographic [CT] scans in 38 patients) was inversely related to local control with larynx preservation: < or = 3.5 cm3, 20 of 23 (87%) versus greater than 3.5 cm3, four of 14 (29%) (P = .0005). There was no apparent relationship between local control after radiotherapy as a function of whether the vocal cord regained mobility or remained fixed during or shortly after completion of treatment. The 5-year absolute and cause-specific survival rates were 54% and 78%, respectively. Multivariate analysis showed that pretreatment tracheostomy was significantly related to diminished cause-specific survival (P = .0345).
Radiotherapy alone results in long-term local-regional control and survival rates that are comparable to those obtained with surgery. It is unclear whether induction or concomitant chemotherapy is associated with improved local-regional control and survival compared with radiotherapy alone.
报告单纯放疗治疗T3期真性声带鳞状细胞癌的结果，并将这些数据与其他治疗方式所获数据进行比较。
1966年9月至1994年8月期间，佛罗里达大学对75例未经治疗的声门型喉T3期鳞状细胞癌患者进行了根治性治疗，其中73例患者仅接受放疗，2例患者随后接受了计划性颈部清扫术。所有患者均未接受辅助化疗。所有患者至少接受了2年的监测，85%的患者最短随访期为5年。没有患者失访。
5年局部控制率和最终局部控制率分别为63%和86%。原发肿瘤体积（38例患者在治疗前计算机断层扫描[CT]上计算得出）与保留喉功能的局部控制呈负相关：≤3.5 cm³，23例中的20例（87%），而＞3.5 cm³，14例中的4例（29%）（P = 0.0005）。放疗后的局部控制与治疗期间或治疗后不久声带是否恢复活动或保持固定之间没有明显关系。5年绝对生存率和病因特异性生存率分别为54%和78%。多因素分析显示，治疗前气管切开术与病因特异性生存率降低显著相关（P = 0.0345）。
单纯放疗可实现长期的局部区域控制和生存率，与手术相当。与单纯放疗相比，诱导化疗或同步化疗是否能改善局部区域控制和生存率尚不清楚。
