Anterior commissure is involved in about 20% of early-stage glottic squamous cell carcinomas (EGSCCs). Treatment outcomes and prognostic factors for EGSCC with anterior commissure involvement (ACI) were evaluated by focusing on hyperfractionated radiotherapy (74.4 Gy in 62 fractions). One-hundred and fifty-three patients with T1–T2 EGSCC were included in this study. The median total doses for T1a, T1b, and T2 were 66, 74.4, and 74.4 Gy, respectively. Overall, 49 (32%) patients had T1a, 38 (25%) had T1b, and 66 (43%) had T2 disease. The median treatment duration was 46 days. The median follow-up duration was 5.1 years. The 10-year overall and cause-specific survival rates were 72% and 97%, respectively. The 10-year local control rates were 94% for T1a, 88% for T1b, and 81% for T2 disease. Local control rates in patients with ACI were slightly better than those in patients without ACI with T1a and T1b diseases; however, the difference was not significant. The 10-year laryngeal preservation rate was 96%. Six patients experienced grade 3 mucositis, and four patients had grade 3 dermatitis. Hyperfractionated radiotherapy was effective for T1 disease with ACI, but insufficient for T2 disease with ACI. Our treatment strategy resulted in excellent laryngeal preservation.
约20%的早期声门型鳞状细胞癌（EGSCC）累及前联合。本研究通过聚焦超分割放疗方案（总剂量74.4 Gy，分62次完成），评估了累及前联合的EGSCC患者的治疗效果及预后因素。本研究共纳入153例T1-T2期EGSCC患者，其中T1a、T1b及T2亚组的中位总照射剂量分别为66 Gy、74.4 Gy和74.4 Gy。总体病例分布为：T1a期49例（32%）、T1b期38例（25%）、T2期66例（43%）。中位治疗周期为46天，中位随访时间5.1年。10年总生存率与疾病特异性生存率分别为72%和97%。10年局部控制率在T1a、T1b及T2亚组分别为94%、88%和81%。在T1a与T1b患者中，累及前联合者的局部控制率略优于未累及者，但差异未达统计学显著性。10年喉功能保留率达96%。治疗期间6例患者出现3级黏膜炎，4例出现3级皮炎。超分割放疗对累及前联合的T1期病变疗效显著，但对累及前联合的T2期病变疗效不足。本治疗方案实现了优异的喉功能保留效果。
肿瘤(癌症)患者之家