Rosier J F, Grégoire V, Counoy H, Octave-Prignot M, Rombaut P, Scalliet P, Vanderlinden F, Hamoir M
Radiation Oncology Department, St.-Luc University Hospital, Brussels, Belgium.
Radiother Oncol. 1998 Aug;48(2):175-83. doi: 10.1016/s0167-8140(98)00058-9.
The aim of this study was to retrospectively compare the efficacy and functional results of three treatment options for T1N0M0 glottic carcinomas applied in a single institution.
One hundred six charts of patients with biopsy-proven T1N0M0 glottic carcinomas treated between 1979 and 1995 were reviewed. There were 81 T1a and 25 T1b tumors. Forty-one patients were treated by radiotherapy (RT) (median dose of 64 Gy), 34 patients were treated by partial laryngectomy (PL) and 31 patients were treated by laser microsurgery (L) of which 10 received postoperative RT for positive margins. In 18 patients, a perceptual voice rating on a visual scale was performed by the patients themselves, three non-speech specialists and two speech therapists.
With a median follow-up time of 63.5 months, the 5- and 10-year loco-regional control probabilities reached 91 and 87%, respectively, without any difference between the treatment groups. After salvage laryngectomy, the 5- and 10-year loco-regional control probabilities reached 97% without any difference between the treatment groups. For the whole population, overall survival reached 78 and 62.4% at 5 and 10 years, respectively. The actuarial incidence of second primary reached 19% at 10 years. Regarding the quality of voice, overall there was a trend towards a worse satisfaction index, more hoarseness and more breathiness after PL than after L or RT.
Our data suggested that assuming proper selection of patients, RT and L yielded similar outcomes and functional results. Local recurrence can be adequately salvaged by surgery. On the other hand, PL appeared to yield similar loco-regional control probability but with a worse quality of voice.
本研究旨在回顾性比较在单一机构应用的三种治疗T1N0M0声门癌方案的疗效和功能结果。
回顾了1979年至1995年间活检证实为T1N0M0声门癌患者的106份病历。有81例T1a肿瘤和25例T1b肿瘤。41例患者接受放射治疗（RT）（中位剂量64 Gy），34例患者接受部分喉切除术（PL），31例患者接受激光显微手术（L），其中10例因切缘阳性接受术后RT。18例患者由患者本人、三名非言语专家和两名言语治疗师进行视觉量表的感知语音评分。
中位随访时间为63.5个月，5年和10年的局部区域控制概率分别达到91%和87%，各治疗组之间无差异。挽救性喉切除术后，5年和10年的局部区域控制概率达到97%，各治疗组之间无差异。对于总体人群，5年和10年的总生存率分别达到78%和62.4%。10年时第二原发癌的精算发病率达到19%。关于语音质量，总体而言，PL术后的满意度指数有变差、声音更嘶哑和呼吸声更多的趋势，比L或RT术后更差。
我们的数据表明，假设患者选择得当，RT和L产生相似的结果和功能结果。手术可以充分挽救局部复发。另一方面，PL似乎产生相似的局部区域控制概率，但语音质量较差。
