Tumour Volume as a Predictor of Treatment Success in Patients with Laryngeal Cancer Treated with Primary Chemoradiotherapy
C Bryant, RJ Amdur, WM Mendenhall, CG Morris, A Mancuso, A Yeung
Hong Kong J Radiol 2013;16:198-202
DOI: 10.12809/hkjr1313159
Objectives: To evaluate the prognostic significance of pretreatment tumour volume in predicting local control, with a functioning larynx, in patients with laryngeal cancer treated with primary chemoradiation.
Methods: Thirty-two patients with American Joint Committee on Cancer stage II-IV squamous cell carcinoma of the larynx were retrospectively reviewed. All patients received concurrent chemoradiation between 2000 and 2007. Tumour volumes were contoured and calculated on computed tomography simulation scans. The median follow-up was 2.1 years. The median radiotherapy dose was 74.4 Gy.
Results: Of the 32 patients, 20 had supraglottic tumours, 11 had glottic tumours, and 1 had a subglottic tumour. For the entire cohort of patients, the 5-year overall survival rate was 45% and the 5-year local control rate for patients with a functional larynx was 66%. In all, 80% of patients with supraglottic tumour volumes of ≤12 cm3 achieved local control with a functioning larynx compared with only 44% of patients with supraglottic tumour volumes of >12 cm3 (p = 0.0268). For glottic cancers, it was not possible to discern a relationship between tumour volume and tumour control.
Conclusions: Pretreatment tumour volume of ≤12 cm3 predicted local control with a functioning larynx in patients with supraglottic squamous cell carcinoma treated with chemoradiation.
中文摘要
以腫瘤體積作為喉癌患者第一線放化療成功的預測指標
C Bryant, RJ Amdur, WM Mendenhall, CG Morris, A Mancuso, A Yeung
目的：本研究針對接受化學放射治療為第一線治療的喉癌患者，評估以治療前的腫瘤體積作為預測局部控制和喉功能正常的預後預測指標的重要性。
方法：回顧分析按美國癌症聯合委員會標準診斷的II至IV期喉鱗狀細胞癌的32名患者。所有患者均於2000年至2007年期間同時接受化療與放療。在電腦斷層模擬掃描上勾畫腫瘤輪廓並計算體積。隨訪時間中位數為2.1年。放療劑量中位數為74.4 Gy。
結果：32名病人中，聲帶上部腫瘤佔20例、聲帶腫瘤佔11例，以及聲帶下部腫瘤佔1例。病人的五年總存活率為45%，腫瘤五年局部控制伴喉功能正常的比率為66%。所有病人中，聲帶上部腫瘤體積≤12 cm3，則腫瘤局部控制伴喉功能正常的比例可達80%；而聲帶上部腫瘤體積>12 cm3的則只有44%（p = 0.0268）。至於聲帶腫瘤的情況，則未能確定腫瘤體積與腫瘤控制的關係。
結論：接受放化療的聲帶上部鱗狀細胞癌患者中，腫瘤體積≤12 cm3可作為腫瘤局部控制伴喉功能正常的預測指標。