진행된 후두암 환자에서 수술 후 방사선 병합치료군과 방사선 후 구제수술군의 치료성적 비교

Abstract

Background and Objectives: Patients with early squamous cell carcinoma of the head and neck are successfully treated with radiation or surgery. But in advanced laryngeal squamous cell carcinoma, combined therapy with irradiation and surgery appears to provide better local control and survival rates than either form of treatment alone. The purpose of this article is to compare the treatment results and survival rates of treatment modality in patients with advanced (stage III, IV) laryngeal carcinoma. Materials and Methods: We analyzed 47 advanced laryngeal carcinoma patients who underwent preoperative radiotherapy and salvage operation due to recurred cancer versus operation with post-operative radiotherapy during the period of 18 years from January 1989 to December 2006. TNM staging of the disease was done by the AJCC staging system issued in 2011. The 5-year survival rate was calculated by Kaplan-Meier method. Results: The overall 5 year survival rate was 48.9%. The 5 year survival rate according to staging showed 78.6%, 36.4% in stage III, IV respectively. The 5 year survival rate according to treatment modality showed 47.1%, 50.0% in pre-operative radiotherapy and salvage operation, post-operative radiotherapy respectively. In the site of treatment failure, 17 had local/regional failure and 6 had distant metastasis. Twelve patients who were treated with functional orgal preservation surgery and post-operative radiotherapy could preserve voice. Conclusions: Although treatment of laryngeal carcinoma could be individualized, surgery and postoperative irradiation can be considered as a option with larynx preservation for advanced laryngeal cancer. (J Clinical Otolaryngol 2014;25:49-55)