Combined radiation therapy and surgery for carcinoma of the supraglottis and pyriform sinus.
Combined radiation therapy and surgery for carcinoma of the supraglottis and pyriform sinus.
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声门上癌和梨状窦癌的联合放射治疗和手术。
DOI：
10.1016/0002-9610(72)90084-0
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发表时间：
1972
期刊：
影响因子：
--
通讯作者：
D. Miller
中科院分区：
文献类型：
--
作者：
C. C. Wang;M. Schulz;D. Miller
根据美国癌症分期联合委员会最近报道的声门癌和声门上癌的最新TNM系统的审查，我们的工作与声门癌和声门上癌的审查现在提出。我们认为T-3和T-4声门癌与T-3和T-4声门上癌相似，尽管后者更容易发生颈部转移。我们的工作结论是，术前使用5,500拉德治疗声门上癌，T-1病变的3年治愈率为90%，T-2病变的治愈率为79%，T3病变的治愈率为63%，T4病变的治愈率为33%。根据我们的病理学研究和对患者的随访，得出的结论是，T-1，N-0或T-2，N-0声门上癌应采用根治性放疗进行治疗。对于具有边界线放射可治愈性的T-3病变，应尝试进行一个放疗试验疗程。如果肿瘤在4,500拉德的放射治疗剂量水平下表现出令人满意的消退，则应继续进行治疗剂量水平，并应保留手术用于放射失败。另一方面，如果肿瘤对放射的反应较差，并且肿瘤较大且广泛或深度溃疡，如T-3和T-4病变，通常与淋巴结转移有关，则建议计划放射和手术的联合方法。
Following a review of the most recently accepted TNM system for glottic carcinoma and for supraglottic carcinoma as recently reported out by the American Joint Committee for Cancer Staging, a review of our work with glottic carcinoma and with supraglottic carcinoma is now presented. It was felt that T‐3 and T‐4 glottic carcinoma simulated T‐3 and T‐4 supraglottic carcinoma, although the latter is more likely to have cervical metastasis.Conclusions of our work using 5,500 rads pre‐operatively for supraglottic carcinoma resulted in a 90 percent three‐year cure rate for T‐1 lesions, 79 percent cure rate for T‐2 lesions, 63 percent cure rate for T‐3 lesions and a 33 percent cure rate for T‐4 lesions. On the basis of our pathological studies and a follow‐up on the patients the conclusion was reached that T‐1, N‐0 or T‐2, N‐0 supraglottic carcinoma should be treated with radical radiation therapy with curative objective. For the T‐3 lesions with border line radiocurability a trial course of radiotherapy should be attempted. If the tumor shows satisfactory regression to a dose level of 4,500 rads of radiation therapy it should be continued to a curative dose level, and surgery should be reserved for radiation failures. On the other hand, if the tumor response to radiation is poor and if the tumor is large and extensive or deeply ulcerated as in T‐3 and T‐4 lesions which are often associated with lymph node metastasis, a planned combined approach of radiation and surgery is advised.