Utility of Sonography for Evaluation of Clinical T1 and T2 Glottic Carcinoma
Utility of Sonography for Evaluation of Clinical T1 and T2 Glottic Carcinoma
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DOI：
10.7863/jum.2009.28.11.1429
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发表时间：
2009-11-01
影响因子：
2.3
通讯作者：
Kumita, Shinichiro
中科院分区：
文献类型：
--
作者：
Kuribayashi, Shigehiko;Miyashita, Tsuguhiro;Kumita, Shinichiro
Objective.本研究的目的是评估超声确定的肿瘤特征与确定性放射治疗的临床T1和T2声门癌局部控制相关的预后影响。方法.在1999年至2005年期间，72例T1和T2声门癌患者通过经皮超声检查评估了肿瘤的可检测性、最大肿瘤尺寸、前连合受累、声门上、声门下或声门旁扩散以及甲状软骨侵犯。局部控制因素分析包括临床特征、超声检查结果和治疗因素。结果41个病灶（57%）在超声检查中被检测为低回声肿块。对于可检测到的T2肿瘤，超声和喉镜检查结果在所有病例中关于扩散到解剖亚部位的情况都是一致的。单纯放射治疗的3年局部控制率为82%。超声特征的单变量分析显示，肿瘤最大尺寸和甲状软骨侵犯预示着局部控制的丧失，而临床或治疗特征均不显着。多因素分析显示，甲状软骨侵犯是局部控制的独立负性预后因素。结论.超声检查提供了关于临床T2声门癌患者放射治疗可能结果的信息，尽管其对T1病变的实用性尚未得到证实。甲状腺软骨侵犯可能是一个独立的负面预测结果。
Objective. The aim of this study was to evaluate the prognostic impact of sonographically determined tumor features in relation to local control of clinical T1 and T2 glottic carcinoma treated by definitive radiation therapy. Methods. Between 1999 and 2005, 72 patients with T1 and T2 glottic carcinoma were evaluated by percutaneous sonography in terms of tumor detectability, maximum tumor dimension, involvement of the anterior commissure, presence of supraglottic, subglottic, or paraglottic spread, and thyroid cartilage invasion. Factor analyses for local control included clinical features, sonographic findings, and treatment factors. Results. Forty-one lesions (57%) were detected as hypoechoic masses on sonography. For detectable T2 tumors, sonographic and laryngoscopic findings were in agreement in all cases with respect to spread to anatomic subsites. The 3-year local control rate with radiation therapy alone was 82%. Univariate analysis of the sonographic characteristics revealed that the maximum tumor dimension and thyroid cartilage invasion predicted a loss of local control, whereas none of the clinical or treatment characteristics was significant. Multivariate analysis showed that thyroid cartilage invasion was an independent negative prognostic factor for local control. Conclusions. Sonography provides information about the likely outcome of radiation therapy for patients with clinical T2 glottic carcinoma, although its utility for T1 lesions is not proven. Thyroid cartilage invasion may be an independent negative predictor of the outcome.