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首页> 外文期刊>Tumori. >Radiotherapy after partial laryngectomy: an analysis of 36 cases and a proposal to optimize radiotherapy.
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Radiotherapy after partial laryngectomy: an analysis of 36 cases and a proposal to optimize radiotherapy.

机译：喉部分切除术后的放射治疗：分析36例病例并提出优化放射治疗的建议。

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AIMS AND BACKGROUND: Laryngeal cancer treatment options include radical surgery, organ preservation surgery evidence of a significant increase in late toxicity with adjuvant radiotherapy after conservative surgery. The aim of this retrospective study was to evaluate the toxicity, local-regional control and overall survival of adjuvant radiotherapy after conservative surgery. METHODS: A total of 36 patients was treated with radiotherapy after partial laryngectomy at the Radiotherapy Department of the Institute for Cancer Treatment and Research (IRCC) of Candiolo and of the Mauriziano Hospital in Turin, between 1994 and 2007. The postoperative treatment doses ranged from 45 to 70.2 Gy with conventional fractionation. The Kaplan-Meier method was applied for statistical analysis. The RTOG-EORTC scale was used to evaluate late and acute toxicity. RESULTS: Overall 5- and 10-year survival was 93% and 47%, respectively. Local control was 93.5% at 5 and was unchanged at 10 years. Grade 2 acute cutaneous and mucous toxicity was 41% and 62%, and grade 3, 6.9% and 3.5%, respectively. Only one patient required percutaneous endoscopic gastrostomy due to severe dysphagia and one patient required temporary tracheostomy for severe acute laryngeal edema (grade 3). Two patients experienced late toxicity greater than grade 3. The median dose to the residual larynx was 59.5 Gy (range, 45-70.2), and the median dose to the neck was 50.4 Gy (range, 39.6 -55.8). CONCLUSIONS: The results of our study showed a dose-dependent increase in the late toxicity trend at doses over and above 60 Gy, which is higher than the cutoff dose reported in the literature. There was no indication from our data that adjuvant postoperative radiotherapy means additional toxicity. The use of highly conformal techniques can further reduce toxicity of the radiotherapy.
机译：目的和背景：喉癌的治疗选择包括根治性手术，器官保存手术，以及保守手术后辅助放疗后晚期毒性显着增加的证据。这项回顾性研究的目的是评估保守手术后辅助放疗的毒性，局部区域控制和总体生存率。方法：1994年至2007年间，在Candiolo癌症治疗和研究中心（IRCC）和都灵毛里齐亚诺医院放疗科的部分喉切除术后，共有36例患者接受了放疗。术后剂量范围为常规分馏时为45至70.2 Gy。将Kaplan-Meier方法应用于统计分析。 RTOG-EORTC量表用于评估晚期和急性毒性。结果：5年和10年总生存率分别为93％和47％。 5岁时的本地控制率为93.5％，而10年时没有变化。 2级急性皮肤和粘液毒性分别为41％和62％，以及3级，6.9％和3.5％。由于严重的吞咽困难，只有一名患者需要经皮内镜下胃造口术，而严重的急性喉头水肿则需要一名患者进行临时气管造口术（3级）。两名患者的晚期毒性大于3级。残余喉的中位剂量为59.5 Gy（范围为45-70.2），而颈部的中位剂量为50.4 Gy（范围为39.6 -55.8）。结论：我们的研究结果表明，超过60 Gy的剂量时，后期毒性趋势呈剂量依赖性增加，高于文献报道的临界剂量。从我们的数据中没有迹象表明术后辅助放疗意味着额外的毒性。使用高度保形的技术可以进一步降低放疗的毒性。

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