Treatment Results of Laryngeal Cancer by Badiotherapy with or Without Surgery

喉癌病患之治療成果

雷德(Louis Tak Lui) ； 陳斯榮(Szu-Jung Chen) ； 丁禮莉(Lai-Lei Ting) ； 王博民(Po-Ming Wang) ； 鍾娜娜(Na-Na Chung) ； 黃昭源(Chao-Yuan Huang)

《放射治療與腫瘤學》 3卷1期 (1996/03) Pp. 21-32

https://doi.org/10.6316/TRO/199603(1)21

摘要

目的：回顧過去十年(1981-1990)在臺大醫院接受放射治療的喉癌病患之治療成果。
材料與方法：這十年中共有133位初次在臺大接受全程放射治療的病患，病理上屬於鱗狀細胞癌。年齡分布自34到84歲，尤以60-69歲的患者最多。男性病患共128位，女性病患則只有5位，比例約爲26:1。第一期到第四期各有25、21、22、65個病例，第四期佔了一半左右，以部位而言，上聲門癌有51位，聲門癌有72位，下聲門癌有10位，聲門癌的病患超過一半。57位病患只接受放射治療，其他76位病患則先接受手術，再接受放射治療。
結果：全體五年存活率是54.9%。第一期到第四期之五年存活率分別爲78.8%、58.3%、54%、44.4%。以部位而言，則爲上聲門癌34.7%、聲門癌70.5%、下聲門癌38.9%。
結論：初期病患大多數只接受放射治療，爾後若復發仍可用救援手術挽救，但三、四期患者若只接受放射治療則其預後較差，且復發後即使再接受二度治療仍然不易控制。所以放射治療後應長期追蹤，俾能早期發現再發而予以治療。

關鍵字

咽喉 ； 腫瘤 ； 放射治療 ； 救援手術 ； 五年存活率

並列摘要

Purpose: To evaluate the therapeutic results of laryngeal cancer patients treated at Department of Radiation Oncology of NTUII over the past ten years (1981-1990).
Materials & Methods: One hundred and thirty-three laryngeal cancer patients treated at our clinic were analyzed clinically. All of them were squamous cell carcinoma. The age of the patients ranged from 34 to 84 years old with the highest incidence at the 60-69 age group. There were 128 male patients and 5 female patients with male to female ratio as 26:1. The numbers of patients in stage I to IV were 25, 21, 22, and 65, respectively. Stage IV patients accounted for about half of the cases. The numbers of supraglottic, glottic, and subglottic cancers were 51, 72, and 10, respectively. Glottic type accounted for more than half of the cases. Fifty-seven patients received primary radiotherapy. The other 76 patients received surgery before radiotherapy.
Results: The overall actuarial five-year survival rate was 54.7%. The actuarial five-year survival rates for patients of stages Ⅰ, Ⅱ,Ⅲ and Ⅳ were 78.7%, 58.3%, 54%, and 44.4%, respectively. The five-year survival rates for supraglottic, glottic and subglottic cancers were 34.7%, 70.5%, and 38.9%, respectively.
Conclusion: Recurrence after radiotherapy was salvaged by surgery satisfactorily in stages I and II, but the prognosis was poor for recurrent patients with initial stages III and IV. A life-long follow-up after radical radiotherapy is essential for early detection of recurrence and earlier salvage to improve the therapeutic result.

並列關鍵字

Larynx ； Neoplasm ； Radiotherapy ； Salvage operation ； Five-year survival rate