Salvage surgery for local recurrence after chemoradiotherapy or radiotherapy in hypopharyngeal cancer patients
Salvage surgery for local recurrence after chemoradiotherapy or radiotherapy in hypopharyngeal cancer patients
复制标题
DOI：
10.1007/s00405-010-1274-3
复制
发表时间：
2010-11-01
影响因子：
2.6
通讯作者：
Fukuda, Satoshi
中科院分区：
文献类型：
--
作者：
Taki, Shigenari;Homma, Akihiro;Fukuda, Satoshi
本研究旨在评价挽救手术在接受放射治疗(RT)或同期放化疗(CRT)的下咽癌(HPC)患者局部复发中的作用。对1991-2005年间收治的104例HPC患者的局部复发率、局部复发率、局部复发率及总生存率进行分析。41例(39.4%)原发灶局部复发，其中仅12例能接受进一步的挽救手术。其中7例患者的疾病得到控制(抢救成功率为17.1%)。RT/CRT组5年总生存率为40.6%，T1、T2、T3、T4原发疾病的抢救成功率分别为33.3%(1/3)、20.0%(4/20)、16.7%(2/12)、0%(0/6)。术后出现咽瘘等严重并发症6例(50.0%)。RT/CRT后局部复发的HPC患者在任何一期T期预后均较差，术后并发症发生率较高。在决定最初的治疗计划时应考虑到这一点，并应仔细决定此类复发病例的抢救手术选择。
This retrospective study aimed to assess the role of salvage surgery for local recurrence in hypopharyngeal cancer (HPC) patients who had received radiotherapy (RT) or concomitant chemoradiotherapy (CRT) as an initial treatment. The local recurrence rate, salvage rate after local recurrence and overall survival rate were investigated in 104 HPC patients who received treatment between 1991 and 2005. Local recurrence in the primary site was observed in 41 patients (rate, 39.4%) of whom only 12 could undergo further salvage surgery. Disease control was achieved in seven of these patients (successful salvage rate, 17.1%). The 5-year overall survival rate was 40.6% in the RT/CRT patient group and successful salvage rates for T1, T2, T3 and T4 primary disease were 33.3% (1/3), 20.0% (4/20), 16.7% (2/12) and 0% (0/6), respectively. Severe postoperative complications such as pharyngo-cutaneous fistula were seen in six patients (50.0%). Prognosis of patients with locally recurring HPC after RT/CRT is poor at any primary T-stage and the incidence of postoperative complication is relatively high. This should be taken into consideration when the initial treatment plan is decided and the choice of salvage surgery for such recurrent cases should be carefully determined.