Surgery-based versus radiation-based treatment strategy for a high metabolic volume laryngeal cancer.
Surgery-based versus radiation-based treatment strategy for a high metabolic volume laryngeal cancer.
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高代谢量喉癌的手术治疗与放射治疗策略。
DOI：
10.1002/lary.26233
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发表时间：
2017
期刊：
影响因子：
2.6
通讯作者：
Oridate N
中科院分区：
文献类型：
--
作者：
abuki K;Sano D;Shiono O;Arai Y;Chiba Y;Tanabe T;Nishimura G;Takahashi M;Taguchi T;Kaneta T;Hata M;Oridate N
目的/假设我们之前报道过原发肿瘤的代谢肿瘤体积（MTV）是喉癌放疗（RT）治疗方案中生存的独立预后因素。本研究的目的是评估MTV喉癌患者手术治疗和放疗治疗在生存结果上的差异。研究设计：个体回顾性队列研究。方法回顾性分析63例原发肿瘤MTV值较高（≥4.9 mL）的喉癌患者的资料。根据主要治疗策略将患者分为两组：手术组22例，RT组41例。分析临床因素和治疗方式与生存率的关系。结果包括年龄、性别、亚位点、T分型、淋巴结转移、治疗方式等在内的多因素分析显示，亚位点（风险比[HR] 2.55，P= 0.043）和治疗方式（风险比[HR] 3.98，P= 0.019）是预后的独立预测因素。手术组和放疗组患者2年无复发生存率和总生存率的Kaplan - Meier曲线分别为74.2%对38.8% （P= 0.025）和80.1%对66.7% （P= 0.078）。结论：采用手术治疗的高代谢体积喉癌患者的无复发生存期和总生存期优于采用放疗治疗的患者。术前MTV评估可用于喉癌患者的治疗策略规划。证据水平：咽喉外科杂志，47 (2):862 - 867,2017
Objective/HypothesisWe previously reported that the metabolic tumor volume (MTV) of a primary tumor was an independent prognostic factor for survival in laryngeal carcinoma treated by radiotherapy (RT)‐based protocol. The purpose of this study was to evaluate the difference in survival outcomes between surgery‐based and RT‐based treatment in patients with a MTV laryngeal cancer.Study DesignAn individual retrospective cohort study.MethodsWe reviewed the records of 63 patients with laryngeal cancer showing a primary tumor with a high MTV value (≥ 4.9 mL). The patients were separated into two groups by primary treatment strategy: 22 patients were included in the surgery group, and 41 patients were included in the RT group. Clinical factors and treatment modalities were analyzed for their association with survival.ResultsMultivariate analysis, including age, sex, subsite, T classification, nodal metastasis, and treatment modality, showed that the subsite (hazard ratio [HR] 2.55,P= 0.043) and treatment modality (HR 3.98,P= 0.019) were independent predictors for survival. The Kaplan‐Meier curves for 2‐year relapse‐free survival rates and overall survival rates for patients in the surgery and RT groups were 74.2% versus 38.8% (P= 0.025) and 80.1% versus 66.7% (P= 0.078).ConclusionsPatients with a high metabolic volume laryngeal cancer treated by a surgery‐based protocol showed better relapse‐free survival and overall survival than did those undergoing RT‐based treatment. Pretreatment MTV assessment could be useful in planning the treatment strategy for patients with a laryngeal cancer.Level of Evidence2b.Laryngoscope, 127:862–867, 2017