Organ preservation with radiotherapy for T1-T2 carcinoma of the pyriform sinus
Organ preservation with radiotherapy for T1-T2 carcinoma of the pyriform sinus
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DOI：
10.1002/hed.1044
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发表时间：
2001-05-01
影响因子：
2.9
通讯作者：
Cassisi, NJ
中科院分区：
文献类型：
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作者：
Amdur, RJ;Mendenhall, WM;Cassisi, NJ
目的。目的：报道梨状窦T1-T2癌放疗合并或不合并颈部清扫的远期疗效。一项对101名在佛罗里达大学接受放射治疗的患者的分析，有或没有计划的颈部解剖以保存器官。放疗后5年局部控制率T1肿瘤为90%，T2病变为80%。在单变量分析中，唯一显著影响局部控制的参数是T1肿瘤的尖端受累。多变量分析显示，没有参数显著影响局部控制。5年病因特异性生存率如下：I-II期，96%；III期，62%；IVA期49%；IVB期33%。绝对生存率：I期，57%；第二阶段，61%；第三阶段，41%；IVA期29%；IVB期，25%。12%的患者出现中度至重度长期并发症。在大部分患者中，单纯放疗或联合有计划的颈部清扫可获得局部控制并保留喉部。治愈的机会与保守手术后观察到的相当，主要并发症的风险较低。辅助化疗的加入不太可能提高器官保存的可能性，但可能改善晚期淋巴结疾病患者的局部区域控制。(C) 2001约翰威利父子公司
Purpose. To report long-term results using radiotherapy with or without a planned neck dissection for T1-T2 carcinoma of the pyriform sinus.Methods. An analysis of 101 patients treated at the University of Florida with RT with or without a planned neck dissection for organ preservation.Results. The 5-year local control rates after RT were 90% for T1 cancers and 80% for T2 lesions. The only parameter that significantly influenced local control in univariate analyses was apex involvement for T1 tumors. Multivariate analysis revealed no parameter that significantly affected local control. Cause-specific survival rates at 5 years were as follows: stage I-II, 96%; stage III, 62%; stage IVA, 49%; and stage IVB, 33%. The absolute survival rates were as follows: stage I, 57%; stage II, 61%; stage III, 41%; stage IVA, 29%; and stage IVB, 25%. Moderate to severe long-term complications developed in 12% of patients.Conclusions. RT alone or combined with a planned neck dissection resulted in local control with larynx preservation in a high proportion of patients. The chance of cure is comparable to that observed after conservation surgery, and the risk of major complications is lower. The addition of adjuvant chemotherapy is unlikely to improve the probability of organ preservation, but might improve locoregional control for patients with advanced nodal disease. (C) 2001 John Wiley & Sons, Inc.