Can pretreatment computed tomography predict local control in T3 squamous cell carcinoma of the glottic larynx treated with definitive radiotherapy?

被引:124
作者
Pameijer, FA
Mancuso, AA
Mendenhall, WM
Parsons, JT
Kubilis, PS
机构
[1] UNIV FLORIDA,COLL MED,DEPT RADIOL,GAINESVILLE,FL 32610
[2] UNIV FLORIDA,COLL MED,DEPT RADIAT ONCOL,GAINESVILLE,FL 32610
[3] UNIV FLORIDA,COLL MED,DEPT BIOSTAT,GAINESVILLE,FL 32610
来源
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS | 1997年 / 37卷 / 05期
关键词
laryngeal neoplasms; tomography; X-ray computed; volumetric analysis; radiotherapy; laryngectomy; cartilage sclerosis;
D O I
10.1016/S0360-3016(96)00626-8
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose: To determine if pretreatment computed tomography (CT) can predict local control in T3 squamous cell carcinoma of the glottic larynx treated with definitive radiotherapy (RT). Methods and Materials: Forty-two patients with previously untreated T3 squamous cell carcinoma of the glottic larynx were treated for cure with RT alone; all had a minimum 2-year follow-up, Tumor volumes and extent were determined by consensus of two head and neck radiologists on pretreatment CT studies, A tumor score was calculated and assigned to each primary lesion depending on the extent of laryngeal spread. Sclerosis of any laryngeal cartilage was recorded. The specific CT parameters assessed were correlated with local control. Results: Tumor volume,vas a significant predictor of local control, For tumors measuring < 3.5 cm(3),local control was achieved in 22 of 26 patients (85%), whereas for tumors greater than or equal to 3.5 cm(3), local control was achieved in 4 of 16 patients (25%) (p = 0.0002), Sensitivity and specificity using this cutpoint were 85% and 75%, respectively. Tumor score as a measure of anatomic extent was also found to be a significant predictor of local control, The local control rate for tumors assigned a low tumor score (less than or equal to 5) was 78% (21 of 27) compared to 33% (5 of 15) for tumors assigned a high tumor score (6, 7, or 8) (p = 0.008), A significant decrease in the local control rate was observed for cancers involving the paraglottic space at the false vocal cord level (14 of 16 [88%] vs, 12/26 [46%]) (p = 0.010), cancers involving the face of the arytenoid (15 of 18 [83%] vs, 11 of 24 [46%]) (p = 0.024), and tumors involving the interarytenoid region (25 of 36 [69%] vs. 1 of 6 [17%]; p = 0.020), There mere 12 patients with sclerosis of both the ipsilateral arytenoid and the adjacent cricoid cartilage. These patients showed a significant decrease in local control (4 of 12 [33%]). Conclusion: Pretreatment CT can stratify patients with T3 glottic carcinoma into groups more or less likely to be locally controlled,vith definitive RT, The local control rate for these tumors can be improved using a CT-based tumor profile; the ideal CT profile for a radiocurable T3 glottic larynx carcinoma is volume < 3.5 cm(3) and no or single laryngeal cartilage sclerosis. (C) 1997 Elsevier Science Inc.
引用
收藏
页码:1011 / 1021
页数:11
相关论文
共 35 条
[1]  
*AM JOINT COMM CAN, 1988, MAN STAG CANC, P39
[2]  
ARCHER CR, 1984, CANCER, V53, P44, DOI 10.1002/1097-0142(19840101)53:1<44::AID-CNCR2820530110>3.0.CO
[3]  
2-5
[4]   NEOPLASTIC INVASION OF THE LARYNGEAL CARTILAGE - COMPARISON OF MR-IMAGING AND CT WITH HISTOPATHOLOGIC CORRELATION [J].
BECKER, M ;
ZBAREN, P ;
LAENG, H ;
STOUPIS, C ;
PORCELLINI, B ;
VOCK, P .
RADIOLOGY, 1995, 194 (03) :661-669
[5]  
CHARLIN B, 1989, J OTOLARYNGOL, V18, P283
[6]  
*DEP VET AFF LAR C, 1991, NEW ENGL J MED, V324, P1685
[7]  
Fletcher GH, 1969, EENT DIGEST, V31, P58
[8]   LARYNGECTOMY ALONE FOR T3 GLOTTIC CANCER [J].
FOOTE, RL ;
OLSEN, KD ;
BUSKIRK, SJ ;
STANLEY, RJ ;
SUMAN, VJ .
HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK, 1994, 16 (05) :406-412
[9]   IRRADIATION ALONE FOR SUPRAGLOTTIC LARYNX-CARCINOMA - CAN CT FINDINGS PREDICT TREATMENT RESULTS [J].
FREEMAN, DE ;
MANCUSO, AA ;
PARSONS, JT ;
MENDENHALL, WM ;
MILLION, RR .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 1990, 19 (02) :485-490
[10]   CORRELATION OF TUMOR VOLUME WITH LOCAL-CONTROL IN LARYNGEAL CARCINOMA TREATED BY RADIOTHERAPY [J].
GILBERT, RW ;
BIRT, D ;
SHULMAN, H ;
FREEMAN, J ;
JENKIN, D ;
MACKENZIE, R ;
SMITH, C .
ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY, 1987, 96 (05) :514-518