声门上型喉癌N_0术前放疗的随机对照研究

Pre-operative Radiotherapy for N_0 Supraglottic Carcinoma:a Randomized Study

声门上型喉癌临床Ｎ＿０１００例，随机对照研究术前放疗４０Ｇｙ对控制颈部淋巴结隐匿性转移的作用。放疗加手术（综合治疗组）４６例，单纯手术５４例，随诊３～１２年。综合治疗组颈部复发率为１５％（７／４６），单纯手术２６％（１４／５４），但无统计学意义，提示４０Ｇｙ的剂量可能对颈部转移的控制不够。放疗加手术组Ｔ＿４颈部复发率３３％，比Ｔ＿（１～３）的３．６％明显增高。因此，建议Ｔ＿４声门上型喉癌应常规做一侧传统的根治性颈清扫术（ＲＮＤ），增加术前或术后放疗剂量到５０Ｇｙ。

A randomized study on 100 patients of No supraglottic squamous cell carcinoma with at least 3 years of follow-up was performed. Surgery alone was used in 56 patients,and combined therapy in 46 patients.The neck failure occurred in 14(26%)patients and 7(15%)patients respectively, there was no statistically difference(P= 0. 287).Neck failure was higher in T_4 stage,therefore, higher dose of radiation and neck dessection should be considered for T_4 supraglottic carcinoma for controlling of regional reeurrence.