International journal of radiation oncology, biology, physics · 1993
Radiotherapy alone or combined with neck dissection for T1-T2 carcinoma of the pyriform sinus: an alternative to conservation surgery.
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Mendenhall W M, Parsons J T, Stringer S P, Cassisi N J, Million R R
Аннотация
PURPOSE: We present our experience with irradiation alone or combined with neck dissection for AJCC T1-T2 pyriform sinus carcinoma and compare our results to those obtained with conservation surgery.
METHODS AND MATERIALS: Seventy-three patients were treated between 1964 and 1990. All patients had a minimum of 2 years of follow-up; no patient was lost to follow-up.
RESULTS: The 5-year rates of local control and ultimate local control were, for Stage T1 (17 patients), 88% and 94%; and for Stage T2 (56 patients), 79% and 91%. Patients with T2 lesions had a significantly higher rate of local control after twice-daily, compared with once-daily, irradiation (p = .04). However, a multivariate analysis of various parameters revealed that none of the variables tested significantly influenced this end point: vocal cord mobility (p = .15), once- vs. twice-daily fractionation (p = .33), T1 vs. T2 (p = .32), apex invasion (p = .58), and pretreatment CT scan (p = .67). Local control with laryngeal voice preservation was obtained in 88% of patients with T1 cancers and 80% of those with T2 cancers. Ultimate control above the clavicles at 5 years according to AJCC stage was as follows: I and II, 100%; III, 78%; IVA, 75%; and IVB, 60%. The probability of cause-specific survival at 5 years was as follows: I and II, 100%; III, 83%; and IVA and IVB, 51%. Overall, nine patients (12%) developed severe complications, one of which was fatal.
CONCLUSION: Compared with available data from series using conservation surgery, radiotherapy alone or followed by neck dissection results in similar rates of local control and survival with a significantly lower risk of fatal complications.
METHODS AND MATERIALS: Seventy-three patients were treated between 1964 and 1990. All patients had a minimum of 2 years of follow-up; no patient was lost to follow-up.
RESULTS: The 5-year rates of local control and ultimate local control were, for Stage T1 (17 patients), 88% and 94%; and for Stage T2 (56 patients), 79% and 91%. Patients with T2 lesions had a significantly higher rate of local control after twice-daily, compared with once-daily, irradiation (p = .04). However, a multivariate analysis of various parameters revealed that none of the variables tested significantly influenced this end point: vocal cord mobility (p = .15), once- vs. twice-daily fractionation (p = .33), T1 vs. T2 (p = .32), apex invasion (p = .58), and pretreatment CT scan (p = .67). Local control with laryngeal voice preservation was obtained in 88% of patients with T1 cancers and 80% of those with T2 cancers. Ultimate control above the clavicles at 5 years according to AJCC stage was as follows: I and II, 100%; III, 78%; IVA, 75%; and IVB, 60%. The probability of cause-specific survival at 5 years was as follows: I and II, 100%; III, 83%; and IVA and IVB, 51%. Overall, nine patients (12%) developed severe complications, one of which was fatal.
CONCLUSION: Compared with available data from series using conservation surgery, radiotherapy alone or followed by neck dissection results in similar rates of local control and survival with a significantly lower risk of fatal complications.