진행된 후두암 환자에서 수술 후 방사선 병합치료군과 방사선 후 구제수술군의 치료성적 비교
The Comparison of Adjuvant Radiotherapy and Salvage Operation of Advanced Laryngeal Carcinoma
1
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Background and Objectives：Patients with early squamous cell carcinoma of the head and neck are successfully treated with radiation or surgery. But in advanced laryngeal squamous cell carcinoma, combined therapy with irradiation and surgery appears to provide better local control and survival rates than either form of treatment alone. The purpose of this article is to compare the treatment results and survival rates of treatment modality in patients with advanced (stage III, IV) laryngeal carcinoma. Materials and Methods：We analyzed 47 advanced laryngeal carcinoma patients who underwent preoperative radiotherapy and salvage operation due to recurred cancer versus operation with post-operative radiotherapy during the period of 18 years from January 1989 to December 2006. TNM staging of the disease was done by the AJCC staging system issued in 2011. The 5-year survival rate was calculated by Kaplan-Meier method. Results：The overall 5 year survival rate was 48.9%. The 5 year survival rate according to staging showed 78.6%, 36.4% in stage III, IV respectively. The 5 year survival rate according to treatment modality showed 47.1%, 50.0% in pre-operative radiotherapy and salvage operation, post-operative radiotherapy respectively. In the site of treatment failure, 17 had local/regional failure and 6 had distant metastasis. Twelve patients who were treated with functional orgal preservation surgery and post-operative radiotherapy could preserve voice. Conclusions：Although treatment of laryngeal carcinoma could be individualized, surgery and postoperative irradiation can be considered as a option with larynx preservation for advanced laryngeal cancer.
Abstract
Background and Objectives：Patients with early squamous cell carcinoma of the head and neck are successfully treated with radiation or surgery. But in advanced laryngeal squamous cell carcinoma, combined therapy with irradiation and surgery appears to provide better local control and survival rates than either form of treatment alone. The purpose of this article is to compare the treatment results and survival rates of treatment modality in patients with advanced (stage III, IV) laryngeal carcinoma. Materials and Methods：We analyzed 47 advanced laryngeal carcinoma patients who underwent preoperative radiotherapy and salvage operation due to recurred cancer versus operation with post-operative radiotherapy during the period of 18 years from January 1989 to December 2006. TNM staging of the disease was done by the AJCC staging system issued in 2011. The 5-year survival rate was calculated by Kaplan-Meier method. Results：The overall 5 year survival rate was 48.9%. The 5 year survival rate according to staging showed 78.6%, 36.4% in stage III, IV respectively. The 5 year survival rate according to treatment modality showed 47.1%, 50.0% in pre-operative radiotherapy and salvage operation, post-operative radiotherapy respectively. In the site of treatment failure, 17 had local/regional failure and 6 had distant metastasis. Twelve patients who were treated with functional orgal preservation surgery and post-operative radiotherapy could preserve voice. Conclusions：Although treatment of laryngeal carcinoma could be individualized, surgery and postoperative irradiation can be considered as a option with larynx preservation for advanced laryngeal cancer.
참고문헌 (20)
- 노종렬, "두경부암의 기능보존수술", 대한이비인후과학회지 두경부외과학, 54(1), pp.1~7 (2011), 대한이비인후과학회
- 하정훈, "두경부암의 맞춤 치료와 두경부외과 의사의 역할", 대한이비인후과학회지 두경부외과학, 55(8), pp.471~475 (2012), 대한이비인후과학회[DOI]
- Varghese BT, "Treatment outcome in patients undergoing surgery for carcinoma larynx and hypopharynx: a follow-up study", Acta Otolaryngol, 129(12), pp.1480~1485 (2009)
- Song DW, "Treatment result in laryngeal cancer patients submitted to surgical treatment", Korean J Otolaryngol-Head Neck Surg, 42(10), pp.1284~1289 (1999)
- Kim KH, "Advanced laryngeal cancer. surgical and nonsurgical management options", Hanyang Med Rev, 29(3), pp.204~209 (2009)
- 태경, "하인두암의 치료성적: 수술 또는 기관보존요법", 대한이비인후과학회지 두경부외과학, 52(8), pp.688~694 (2009), 대한이비인후과학회
- Tupchong L, "Randomized study of preoperative versus postoperative radiation therapy in advanced head and neck carcinoma: long-term follow-up of RTOG study 73-03", Int J Radiat Oncol Biol Phys, 20(1), pp.21~28 (1991)
- Wennerberg J, "Pre versus post-operative radiotherapy of resectable squamous cell carcinoma of the head and neck", Acta Otolaryngol, 115(4), pp.465~474 (1995)
- 김지희, "재발성 성문상부암의 구제치료 결과", 대한이비인후과학회지 두경부외과학, 52(5), pp.419~425 (2009), 대한이비인후과학회
- Piazza C, "Salvage surgery after radiotherapy for laryngeal cancer: from endoscopic resections to open-neck partial and total laryngectomies", Arch Otolaryngol Head Neck Surg, 133(10), pp.1037~1043 (2007)
- Karatzanis AD, "Management of locally advanced laryngeal cancer", J Otolaryngol Head Neck Surg, 43(1), pp.4~ (2014)
- Piazza C1, "Salvage surgery after radiotherapy for laryngeal cancer: from endoscopic resections to open-neck partial and total laryngectomies", Arch Otolaryngol Head Neck Surg, 133(10), pp.1037~1043 (2007)
- Kim DJ, "Failure anaysis of radical radiotherapy in laryngeal cancer", Korean J Otolaryngol-Head Neck Surg, 36(2), pp.225~233 (1993)
- Nguyen-Tan PF, "Treatment results and prognostic factors of adavanced T3-4 laryngeal carcinoma: the university of california, san francisco (UCSF) and stanford university hosipiral (SUH) experience", Int J Radiat Oncol Biol Phys, 50(5), pp.1172~1180 (2001)
- MacKenzie RG, "Comparing treatment outcomes of radiotherapy and surgery in locally advanced carcinoma of the larynx: a comparison limited to patients eligible for surgery", Int J Radiat Oncol Biol Phys, 47(1), pp.65~71 (2000)
- Lavertu P, "Comparison of surgical complications after organ-preservation therapy in patients with stage III or IV squamous cell head and neck cancer", Arch Otolaryngol Head Neck Surg, 124(4), pp.401~406 (1998)
- Varghese BT, "Treatment outcome in patients undergoing surgery for carcinoma larynx and hypopharynx: a follow-up study", Acta Otolaryngol, 129(12), pp.1480~1485 (2009)
- Sessions DG, "Supraglottic laryngeal cancer: analysis of treatment results", Laryngoscope, 115(8), pp.1402~1410 (2005)
- Spector GJ, "Management of stage IV glottic carcinoma:therapeutic outcomes", Laryngoscope, 114(8), pp.1438~1446 (2004)
- Wang SG, "Supracricoid partial laryngectomy for recurrent laryngeal cancer", J Clinical Otolaryngol, 11(2), pp.280~285 (2000)