대한두경부종양학회지 (Korean Journal of Head & Neck Oncology)

  • 제23권1호
  • /
  • Pages.3-8
  • /
  • 2007
  • /
  • 1229-5183(pISSN)
  • /
  • 2586-2553(eISSN)
대한두경부종양학회 (The Korean Society for Head and Neck Oncology)
권호 표지

편도 편평상피암의 수술적 치료와 비수술적 치료의 비교：87명 환자의 후향적 분석

Comparison between Surgical and Non-Surgical Treatment of Squamous Cell Carcinoma of Tonsil：Retrospective Analysis of 87 Patients

  • 구동회 (울산대학교 의과대학 서울아산병원 내과학교실) ;
  • 이상욱 (울산대학교 의과대학 서울아산병원 방사선종양학교실) ;
  • 송시열 (울산대학교 의과대학 서울아산병원 방사선종양학교실) ;
  • 김상윤 (울산대학교 의과대학 서울아산병원 이비인후과학교실) ;
  • 남순열 (울산대학교 의과대학 서울아산병원 이비인후과학교실) ;
  • 최승호 (울산대학교 의과대학 서울아산병원 이비인후과학교실) ;
  • 노종열 (울산대학교 의과대학 서울아산병원 이비인후과학교실) ;
  • 조경자 (울산대학교 의과대학 서울아산병원 병리학교실) ;
  • 안진희 (울산대학교 의과대학 서울아산병원 내과학교실) ;
  • 김성배 (울산대학교 의과대학 서울아산병원 내과학교실)
  • Koo, Dong-Hoe (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Lee, Sang-Wook (Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Song, Si-Yeol (Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Sang-Yoon (Department of Otorhinolaryngology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Nam, Soon-Yuhl (Department of Otorhinolaryngology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Choi, Seung-Ho (Department of Otorhinolaryngology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Roh, Jong-Lyel (Department of Otorhinolaryngology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Cho, Kyung-Ja (Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Ahn, Jin-Hee (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Sung-Bae (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine)
  • 발행 : 2007.05.31
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

연구목적：국소적 진행성 편도암환자에서 수술적치료와 비수술적치료의 결과를 비교 분석하고자 하였다. 연구방법 : 수술 후 보조방사선요법을 시행한 군과 유도화학요법 시행 유무에 상관없이 근치적 방사선 치료 또는 항암화학-방사선 동시치료를 받은 비수술군의 임상결과를 후향적으로 분석하였다. 연구결과：52.4개월의 중앙 추적기간결과, 대상환자의 중앙 연령은 53세 이었다. 대상 환자 중 병기 Ⅲ, Ⅳ기 환자는 72명(82.8%)이었고, 49명(56.3%)이 수술적 치료를, 38명(43.7%)명이 비수술적 치료를 받았다. 방사선 조사량외에 양군간의 차이는 없었다 (수술군：60.4Gy, 비수술군：70.2Gy, p=0.02). 비수술군의 전체 생존율은 81.6%이었다. 수술군의 8명(16.3%), 비수술군의 6명 (15.8%)에서 재발이 발생하였다. 흥미로운 사실은 원격재발은 2명 모두 수술군에서 발생하였다. 병기 III, IV기의 5년 무병생존율과 전체생존율은 수술군이 각각 82.1%, 86.9%이고, 비수술군이 각각 83.3%, 83.1%이었다(p=0.96, p=0.96). 결론：수술적 치료에 비해 비수술적 치료가 활동능력이 불량한 환자에게 선호되었을 가능성이 있었음에도 불구하고, 치료성적은 비슷하였다. 편도암에서 수술적 치료와 비수술적 치료의 전향적 무작위 비교연구가 필요하다.

키워드

참고문헌

  1. The Department of Veterans Affairs Laryngeal Cancer Study Group: Induction chemotherapy plus radiation compared with surgery plus radiation in patients with advanced laryngeal cancer. N Engl J Med. 1991;324:1685-1690 https://doi.org/10.1056/NEJM199106133242402
  2. Lefebvre JL, Chevalier D, Luboinski B, Kirkpatrick A, Collette L, Sahmoud T: Larynx preservation in pyriform sinus cancer: preliminary results of a European Organization for Research and Treatment of Cancer phase III trial. EORTC Head and Neck Cancer Cooperative Group. J Natl Cancer Inst. 1996;88:890-899 https://doi.org/10.1093/jnci/88.13.890
  3. Adelstein DJ: Recent randomized trials of chemoradiation in the management of locally advanced head and neck cancer. Curr Opin Oncol. 1998;10:213-218 https://doi.org/10.1097/00001622-199805000-00007
  4. Calais G, Alfonsi M, Bardet E, et al: Randomized trial of radiation therapy versus concomitant chemotherapy and radiation therapy for advanced-stage oropharynx carcinoma. J Natl Cancer Inst. 1999;91:2081-2086 https://doi.org/10.1093/jnci/91.24.2081
  5. Wendt TG, Grabenbauer GG, Rodel CM, et al: Simultaneous radiochemotherapy versus radiotherapy alone in advanced head and neck cancer: a randomized multicenter study. J Clin Oncol. 1988;16:1318-1324
  6. El-Sayed S, Nelson N: Adjuvant and adjunctive chemotherapy in the management of squamous cell carcinoma of the head and neck region. A meta-analysis of prospective and randomized trials. J Clin Oncol. 1996;14:838-847 https://doi.org/10.1200/JCO.1996.14.3.838
  7. Pignon JP, Bourhis J, Domenge C, Designe L: Chemotherapy added to locoregional treatment for head and neck squamouscell carcinoma: three meta-analyses of updated individual data. MACH-NC Collaborative Group. Meta-Analysis of Chemotherapy on Head and Neck Cancer. Lancet. 2000;355: 949-955 https://doi.org/10.1016/S0140-6736(00)90011-4
  8. Soo KC, Tan EH, Wee J, Lim D et al: Surgery and adjuvant radiotherapy vs concurrent chemoradiotherapy in stage III/IV nonmetastatic squamous cell head and neck cancer: a randomised comparison. Br J Cancer. 2005;93:279-286 https://doi.org/10.1038/sj.bjc.6602696
  9. Hicks WL Jr, Kuriakose MA, Loree TR, et al: Surgery versus radiation therapy as single-modality treatment of tonsillar fossa carcinoma: the Roswell Park Cancer Institute experience(1971- 1991). Laryngoscope. 1998;108:1014-1019 https://doi.org/10.1097/00005537-199807000-00012
  10. Deleyiannis FW, Weymuller EA Jr, Coltreara MD: Quality of life of disease-free survivors of advanced(stage III or IV) oropharyngeal cancer. Head & Neck. 1997;19:466-473 https://doi.org/10.1002/(SICI)1097-0347(199709)19:6<466::AID-HED2>3.0.CO;2-X
  11. Chang AR, Wu HG, Park CI, Kim KH, Sung MW, Heo DS: Retrospective analysis of the treatment results for patients with squamous cell carcinoma of tonsil. Cancer Res Treat. 2005;32: 92-97 https://doi.org/10.4143/crt.2005.37.2.92
  12. Amornmarn R, Prempree T, Jaiwatana J, Wizenberg MJ: Radiation management of carcinoma of the tonsillar region. Cancer. 1984;54:1293-1299 https://doi.org/10.1002/1097-0142(19841001)54:7<1293::AID-CNCR2820540711>3.0.CO;2-4
  13. Bryce DP, Bird RJ: Symposium: adjuvant cancer therapy of head and neck tumors. Laryngoscope. 1979;89:561-566
  14. Gwozdz JT, Morrison WH, Garden AS, Weber RS, Peters LJ, Ang KK: Concomitant boost radiotherapy for squamous carcinoma of the tonsillar fossa. Int J Radiat Oncol Biol Phys. 1997;39: 127-135
  15. Mendenhall WM, Amdur RJ, Stringer SP, Villaret DB, Cassisi NJ: Radiation therapy for squamous cell carcinoma of the tonsillar region: a preferred alternative to surgery? J Clin Oncol. 2000; 18:2219-2225 https://doi.org/10.1200/JCO.2000.18.11.2219
  16. Hanna E, Alexiou M, Morgan J, et al: Intensive chemoradiotherapy as a primary treatment for organ preservation in patients with advanced cancer of the head and neck: efficacy, toxic effects, and limitations. Arch Otolaryngol Head Neck Surg. 2004;130: 861-867 https://doi.org/10.1001/archotol.130.7.861
  17. Pradier O, Christiansen H, Ambrosch P, Kron M, Schmidberger H, Hess CF: A long-term follow-up study after split-course irradiation with concurrent chemotherapy(carboplatin) for locally advanced head and neck cancer and a review of the literature. ORL J Otorhinolaryngol Relat Spec. 2004;66:325-331 https://doi.org/10.1159/000081890
  18. Adelstein DJ, Li Y, Adams GL, et al: An intergroup phase III comparison of standard radiation therapy and two schedules of concurrent chemoradiotherapy in patients with unresectable squamous cell head and neck cancer. J Clin Oncol. 2003;21:92-98 https://doi.org/10.1200/JCO.2003.01.008