T1-T2 성문암의 방사선 치료 성적 및 예후인자 분석
Prognostic Factors for Local Control and Survival in T1-T2 Glottic Cancer
대한암학회지 1997년 29권 6호 p.984 ~ 991
소속 상세정보
박찬일/Charn Il Park
신경환/박석원/신성수/김광현/Kyung Hwan Shin/Suk Won Park/Seong Soo Shin/Kwang Hyun Kim
KMID : 0360319970290060984
Abstract
서론
후두암은 두경부 암중 가장 높은 빈도로 발생하며, 후두암중에서는 성문암이 가장 흔한
것으로 알려져 있다. 성문암은 특징적인 증상인 애성이 질병 경과의 초기단계에 나타나 조
기 발견이 가능하고, 림프조직이 거의 없어 림프절 전이가 잘 일어나지 않기 때문에 높은
완치율을 나타내는 질병이다. 따라서 조기 성문암 치료의 목표는 성대가 보존된 상태에서
암이 치유되는 것이므로, 음성 보존이 가능한 근치적 방사선치료를 우선 시도한 후, 치료 실
패시 후두반적출술 또는 후두전적출술 등의 구제수술(salvage operation)을 시행하는 것이
타당한 것으로 판단된다.
본 연구에서는 근치적 목적의 방사선치료를 받았던 T1, T2 병기의 성문암 환자들을 대상
으로 생존율, 무병생존율, 질병특이생존율 (cause specific survival)과 국소제어율에 영향을
미치는 예후인자를 분석하였다. 그리고 음성보존이 가능하였던 환자의 비율을 살펴 방사선
치료를 일차적 치료로서 시행하는 것이 타당한가에 대하여 고찰하였다
#초록#
Purpose : To evaluate the efficacy of radiotherapy as the first treatment of T1-T2
golttic cancers, we analyzed survival rates, local control rates, and voice preservation
rates retrospectively Furthermore, prognostic factors potentially influencing local control
and incidence of second primary tumors were analyzed.
Materials and Methods : One hundred patients with T1-T2 glottic cancer were
irradiated between February 1989 and July 1991. Median follow-up time was 80 months.
1) Factors analyzed for each patient included age, stage, anterior commissure
involvement, fraction size, field size, total dose and treatment time. 2) Survival analysis
methods were employed to assess the effects of these factors in local control and
survival rates. All patients received Co-60 irradiation, one daily fraction of 1.75 ∼2.0 Gy
to doses of 60∼72 Gy.
Results : The overall survival rate, disease free survival rate and cause specific
survival rates for all patients at 5 year were 80.7%, 78.6% and 87.3%, respectively. The
5-year overall survival rates for patients with 71,2 were 82.8% and 76.9%, respectively
Overall treatment time of 50 days or less was uniquely found to have superior impact
on local control rate to that of more than 50 days in univariate prognostic factor
analysis (p=0.0494), and showed statistical trend in multivariate analysis (p=0.0577).
Fourteen patients who had showed relapse after radiotherapy underwent salvage
operation, among whom nine patients were cured. The 5-year local control rate for all
patients after radiotherapy was 79% and ultimate local control rate was 87%. Voice
preservation rate after radiotherapy and salvage operation was 87.6%. The second
primary cancer developed in 9 patients (9%).
Conclusion : Radiotherapy which showed high survival rates and voice preservation
rate proved to be the optimal initial treatment for patients with T1-T2 glottic cancer.
Prolongation of overall treatment should be avoided as the overall treatment was found
to have a significant impact on the local control of tumor. The close follow-up and
prevention should be needed to decrease the death rate by second primary tumor.
키워드
Glottic cancer; Radiotherapy; Voice preservation; Survival;
원문 및 링크아웃 정보
등재저널 정보