조기성문암에서 방사선치료 실패의 위험인자와 구제수술의 치료결과
Recurrence Risk Factors after Radiotherapy in Early Glottic Cancer and Outcome of Salvage Treatment
1
조회
0
다운로드
0
인용
0
참고문헌
초록
The aim of this study was to find risk factors for recurrence after curative radiotherapy in early glottic cancer and to analyze the result of treatment between salvage total laryngectomy and salvage conservation laryngectomy for recurrent glottic cancer. Subjects and Method：A retrospective analysis was performed for patients of 45 cases of early glottic cancer who were treated with curative radiotherapy from 1997 to 2004. The risk factors analyzed for recurrence in early glottic cancer were gender, age, anterior involvement, bilaterality, T stage and radiotherapy interruption. Fourteen patients who underwent salvage laryngectomy for recurrent glottic cancer were analyzed by Kaplan-Myer method to assess the results of salvage total laryngectomy and salvage conservation laryngectomy. Results：Forty-two patients were male and only 3 patients were female, with the median age of 62.4 years. Radiotherapy interruption was found to be a risk factor significantly influencing recurrence in univariate and multivariate analyses. The 5-year overall survival rate in salvage total laryngectomy was 77% and that in salvage conservation laryngectomy was 75%. Conclusion：When a curative radiotherapy was interrupted in early glottic cancer before total dosage irradiation, the possibility of recurrence must be considered. In such cases, by choosing an adequate patient group combined with a proper surgical technique, optimal treatment results can be obtained by salvage conser-vation laryngectomy. (Korean J Otorhinolaryngol-Head Neck Surg 2008;51:261-5)
Abstract
The aim of this study was to find risk factors for recurrence after curative radiotherapy in early glottic cancer and to analyze the result of treatment between salvage total laryngectomy and salvage conservation laryngectomy for recurrent glottic cancer. Subjects and Method：A retrospective analysis was performed for patients of 45 cases of early glottic cancer who were treated with curative radiotherapy from 1997 to 2004. The risk factors analyzed for recurrence in early glottic cancer were gender, age, anterior involvement, bilaterality, T stage and radiotherapy interruption. Fourteen patients who underwent salvage laryngectomy for recurrent glottic cancer were analyzed by Kaplan-Myer method to assess the results of salvage total laryngectomy and salvage conservation laryngectomy. Results：Forty-two patients were male and only 3 patients were female, with the median age of 62.4 years. Radiotherapy interruption was found to be a risk factor significantly influencing recurrence in univariate and multivariate analyses. The 5-year overall survival rate in salvage total laryngectomy was 77% and that in salvage conservation laryngectomy was 75%. Conclusion：When a curative radiotherapy was interrupted in early glottic cancer before total dosage irradiation, the possibility of recurrence must be considered. In such cases, by choosing an adequate patient group combined with a proper surgical technique, optimal treatment results can be obtained by salvage conser-vation laryngectomy. (Korean J Otorhinolaryngol-Head Neck Surg 2008;51:261-5)
참고문헌 (18)
- Mendenhall WM, "Early stage cancer of the larynx, in : Head and neck cancer. 2nd ed", pp.352~380 (2004), Lippincott Williams & Wilkins
- Cragle SP, "Laser cordectomy or radiotherapy: Cure rates, communication, and cost", Otolaryngol Head Neck Surg, 108(6), pp.648~654 (1993)
- de Campora E, "External versus endoscopic approach in the surgical treatment of glottic cancer", Eur Arch Otorhinolaryngol, 258(10), pp.533~536 (2001)
- Cragle SP, "Laser cordectomy or radiotherapy: Cure rates, communication, and cost", Otolaryngol Head Neck Surg, 108(6), pp.648~654 (1993)
- Kim KH, "Treatment result of laryngeal cancer", Korean J Otolaryngol-Head Neck Surg, 31(5), pp.783~791 (1988)
- Sewnaik A, "Partial laryngectomy for recurrent glottic carcinoma after radiotherapy", Head Neck, 27(2), pp.101~107 (2005)
- Kanonier G, "Radiotherapy in early glottic carcinoma", Ann Otol Rhinol Laryngol, 105(10), pp.759~763 (1996)
- 박지훈, "초기 성문암에서 레이저 성대절제술과 방사선치료 결과", 대한이비인후과학회지 두경부외과학, 45(2), pp.159~163 (2002), 대한이비인후과학회
- Zouhair A, "Decreased local control following radiation therapy alone in earlystage glottic carcinoma with anterior commissure extension", Strahlenther Onkol, 180(2), pp.84~90 (2004)
- Maheshwar AA, "Radiotherapy for T1 glottic carcinoma: Impact of anterior commissure involvement", J Laryngol Otol, 115(4), pp.298~301 (2001)
- Lohynska R, "Predictors of local failure in early laryngeal cancer", Neoplasma, 52(6), pp.483~488 (2005)
- Shimm DS, "Early-stage glottic carcinomas: Effect of tumor location and full-length involvement on local tumor recurrence after radiation therapy", Radiology, 192(3), pp.873~875 (1994)
- Chatani M, "Radiation therapy for early glottic carcinoma (T1N0M0): The adverse effect of treatment interruption", Strahlenther Onkol, 173(10), pp.502~506 (1997)
- Groome PA, "Compromised local control due to treatment interruptions and late treatment breaks in early glottic cancer: Populationbased outcomes study supporting need for intensified treatment schedules", Int J Radiat Oncol Biol Phys, 64(4), pp.1002~1012 (2006)
- Spriano G, "Supracricoid partial laryngectomy as salvage surgery after radiation failure", Head Neck, 24(8), pp.759~765 (2002)
- Ward PH, "enigma of post-radiation edema and recurrent or residual carcinoma of the larynx", Laryngoscope, 85(3), pp.522~529 (1975)
- Lavey RS, "Partial laryngectomy for glottic cancer after high-dose radiotherapy", Am J Surg, 162(4), pp.341~344 (1991)
- Shaw HJ, "Role of partial laryngectomy after irradiation in the treatment of laryngeal cancer: A view from the United Kingdom", Ann Otol Rhinol Laryngol, 100(4), pp.268~273 (1991)