The effectiveness of chemoradiation therapy and salvage surgery for hypopharyngeal squamous cell carcinoma.
The effectiveness of chemoradiation therapy and salvage surgery for hypopharyngeal squamous cell carcinoma.
复制标题
放化疗和抢救手术治疗下咽鳞状细胞癌的有效性。
DOI：
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发表时间：
2013
影响因子：
2.4
通讯作者：
S. Fujii
中科院分区：
文献类型：
--
作者：
Kensuke Suzuki;R. Hayashi;M. Ebihara;M. Miyazaki;T. Shinozaki;H. Daiko;M. Sakuraba;S. Zenda;M. Tahara;S. Fujii
目的
本研究的目的是评估下咽鳞状细胞癌根治性放化疗后挽救性手术的结果。
方法
这是一项回顾性队列研究。2004年1月至2009年1月期间，79名未经治疗的下咽鳞状细胞癌患者接受了明确的放化疗，其中24名患者复发并在日本千叶国立癌症中心东医院接受了挽救手术，入组了本研究。
结果
在24例接受挽救性手术的患者中，13例为孤立性局部失败，8例为孤立性颈部失败，3例为合并局部和区域失败。8例（33.3%）患者发生术后手术并发症。在24例接受挽救手术的患者中，12例（50%）复发。在这些患者中，有11例因挽救治疗失败而死亡，挽救治疗失败定义为挽救治疗后出现任何复发。挽救治疗失败后癌症特异性死亡的原因是肿瘤局部复发（n = 6）（其中1例伴有远处转移）和单纯远处转移（n = 5）。在我们的患者组中没有观察到挽救手术后局部复发。24个月无病生存率和总生存率分别为49.0%和50.0%。那些最初表现为不可切除疾病的患者的总生存率低于那些最初表现为可切除疾病的患者（P = 0.0003）。
结论
在进行挽救手术的患者中，肿瘤学结局是可接受的。那些最初表现为不可切除疾病的患者预后不良。
OBJECTIVE
The objective of this study was to evaluate the results of salvage surgery after definitive chemoradiation for hypopharyngeal squamous cell carcinoma.
METHODS
This was a retrospective cohort study. Of the 79 patients with previously untreated hypopharyngeal squamous cell carcinoma who received definitive chemoradiation from January 2004 to January 2009, 24 who had recurrence and underwent salvage surgery at the National Cancer Center Hospital East, Chiba, Japan, were enrolled in this study.
RESULTS
Of the 24 patients who underwent salvage surgery with curative intent, 13 had an isolated local failure, eight had an isolated neck failure and three had combined local and regional failure. Postoperative surgical complications were observed in eight (33.3%) patients. Of the 24 patients undergoing salvage surgery, 12 (50%) had recurrence. In 11 of these patients, death ensued from salvage failure, defined as the presence of any recurrence after salvage treatment. The causes of cancer-specific death ensuing from salvage failure were regional recurrence of the tumor (n = 6) (one of whom had concurrent distant metastases) and distant metastases alone (n = 5). No local recurrence after salvage surgery was observed in our group of patients. The disease-free and overall 24-month survival rates were 49.0 and 50.0%, respectively. Those patients who initially presented with unresectable disease had lower overall survival compared with those who initially presented with resectable disease (P = 0.0003).
CONCLUSIONS
The oncologic outcomes were acceptable in those patients in whom salvage surgery was carried out. Those who initially presented with unresectable disease had a poor prognosis.
影响因子：
158.5
作者：
Forastiere, AA;Goepfert, H;Cooper, J
通讯作者：
Cooper, J
影响因子：
45.3
作者：
Adelstein, DJ;Li, Y;Forastiere, AA
通讯作者：
Forastiere, AA