PDF(Pubmed)
Abstract：
Anterior commissure is involved in about 20% of early-stage glottic squamous cell carcinomas (EGSCCs). Treatment outcomes and prognostic factors for EGSCC with anterior commissure involvement (ACI) were evaluated by focusing on hyperfractionated radiotherapy (74.4 Gy in 62 fractions). One-hundred and fifty-three patients with T1-T2 EGSCC were included in this study. The median total doses for T1a, T1b, and T2 were 66, 74.4, and 74.4 Gy, respectively. Overall, 49 (32%) patients had T1a, 38 (25%) had T1b, and 66 (43%) had T2 disease. The median treatment duration was 46 days. The median follow-up duration was 5.1 years. The 10-year overall and cause-specific survival rates were 72% and 97%, respectively. The 10-year local control rates were 94% for T1a, 88% for T1b, and 81% for T2 disease. Local control rates in patients with ACI were slightly better than those in patients without ACI with T1a and T1b diseases; however, the difference was not significant. The 10-year laryngeal preservation rate was 96%. Six patients experienced grade 3 mucositis, and four patients had grade 3 dermatitis. Hyperfractionated radiotherapy was effective for T1 disease with ACI, but insufficient for T2 disease with ACI. Our treatment strategy resulted in excellent laryngeal preservation.
摘要：
约20％的早期声门鳞状细胞癌（EGSCC）涉及前连合。以超分割放疗（62个分次74.4Gy）为重点，评估了前连合受累（ACI）的EGSCC的治疗结果和预后因素。本研究包括153名T1-T2EGSCC患者。T1a的中位总剂量，T1b,和T2分别为66、74.4和74.4Gy，分别。总的来说,49例（32%）患者有T1a，38（25%）患有T1b，和66（43％）有T2疾病。中位治疗持续时间为46天。中位随访时间为5.1年。10年总体生存率和病因特异性生存率分别为72%和97%，分别。T1a的10年局部控制率为94%，T1b的88%，81%为T2病。ACI患者的局部控制率略优于T1a和T1b疾病的无ACI患者；然而，差异不显著。10年喉部保存率为96%。六名患者经历了3级粘膜炎，4例患者有3级皮炎。超分割放疗对ACI的T1疾病有效，但对ACI的T2疾病不足。我们的治疗策略导致出色的喉保存。
