Radiation Oncology Journal

  • 제27권4호
  • /
  • Pages.173-180
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  • 2009
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  • 2234-1900(pISSN)
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  • 2234-3156(eISSN)
대한방사선종양학회 (The Korean Society for Radiation Oncology)
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외이도 및 중이 편평상피암의 방사선치료

Role of Radiotherapy for Squamous Cell Carcinoma of the External Auditory Canal and Middle Ear

  • 강현철 (서울대학교 의과대학 방사선종양학교실) ;
  • 우홍균 (서울대학교 의과대학 방사선종양학교실) ;
  • 이지혜 (서울대학교 의과대학 방사선종양학교실) ;
  • 박찬일 (서울대학교 의과대학 방사선종양학교실) ;
  • 김종선 (서울대학교 의과대학 이비인후과학교실) ;
  • 오승하 (서울대학교 의과대학 이비인후과학교실) ;
  • 허대석 (서울대학교 의과대학 내과학교실) ;
  • 김동완 (서울대학교 의과대학 내과학교실) ;
  • 이세훈 (서울대학교 의과대학 내과학교실)
  • Kang, Hyun-Cheol (Departments of Radiation Oncology, Seoul National University College of Medicine) ;
  • Wu, Hong-Gyun (Departments of Radiation Oncology, Seoul National University College of Medicine) ;
  • Lee, Ji-Hye (Departments of Radiation Oncology, Seoul National University College of Medicine) ;
  • Park, Charn-Il (Departments of Radiation Oncology, Seoul National University College of Medicine) ;
  • Kim, Chong-Sun (Departments of Otolaryngology and Head and Neck Surgery, Seoul National University College of Medicine) ;
  • Oh, Seung-Ha (Departments of Otolaryngology and Head and Neck Surgery, Seoul National University College of Medicine) ;
  • Heo, Dae-Seog (Internal Medicine, Seoul National University College of Medicine) ;
  • Kim, Dong-Wan (Internal Medicine, Seoul National University College of Medicine) ;
  • Lee, Se-Hoon (Internal Medicine, Seoul National University College of Medicine)
  • 투고 : 2009.08.03
  • 심사 : 2009.10.07
  • 발행 : 2009.12.31
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초록

목 적: 본 연구에서는 외이도 및 중이에 생긴 편평상피암의 치료에 있어서 방사선치료의 역할에 대해 알아보고자 한다. 대상 및 방법: 1981년부터 2007년까지 외이도 및 중이에 생긴 편평상피암으로 치료 받은 총 35명의 기록을 후향적으로 분석하였다. 13명은 방사선치료 단독, 4명은 수술 단독, 18명은 수술 방사선 병용 요법으로 치료하였다. 방사선치료 단독군에서 조사된 중앙 방사선량은 66 Gy (범위, 39~70 Gy)이었고, 수술 방사선 병용 치료군에서는 61.2 Gy (범위, 44~70 Gy)를 조사하였다. 치료 방법에 따른 질병특이생존율 및 무국소진행생존율을 비교하였으며 추적관찰기간은 0.2~14.6년(중앙값 2.8년)이었다. 결 과: 3년 질병특이생존율 및 무국소진행생존율은 각각 80%, 63%이었다. 질병특이생존율에 관한 단변량 분석에서 전신수행상태 및 잔여 종양의 유무가 통계적인 유의성을 보여주었고, 무국소진행생존율에는 전신수행상태 및 조직학적 등급이 유의하였다. 치료 후 잔여 종양은 방사선 단독 치료군(69%)에서 수술 방사선 병용 치료군(28%)에 비해 많이 관찰 되었다. 비록 양군간에 질병특이생존율은 통계학적인 차이를 보이지 않았지만 방사선 단독 치료군에서 병용 치료군에 비해 조기 국소 재발의 빈도가 높았다. 결 론: 외이도 및 중이의 편평상피암 환자에서 방사선 단독 치료는 질병특이생존율에 있어서 수술 방사선 병용 치료와 유사한 결과를 보여주었다. 그러나 낮은 국소 제어율을 높이기 위한 치료 방법의 향상이 있어야 할 것으로 생각된다.

Purpose: To investigate the role of radiotherapy for squamous cell carcinomas of the external auditory canal and middle ear. Materials and Methods: A series of 35 patients who were treated at a single institution from 1981 through 2007 were retrospectively analyzed. Thirteen patients were treated by radiotherapy alone; four by surgery only and 18 by a combination of surgery and radiotherapy. The total radiation dose ranged from 39~70 Gy (median, 66 Gy) in 13~35 fractions for radiotherapy alone and 44~70 Gy (median, 61.2 Gy) in 22~37 fractions for the combined therapy. Clinical end-points were the cause of specific survival (CSS) and local relapse-free survival (LRFS). The median follow-up time was 2.8 years (range, 0.2~14.6 years). Results: The 3-year CSS and LRFS rate was 80% and 63%, respectively. Based on a univariate analysis, performance status and residual disease after treatment had a significant impact on CSS; performance status and histologic grade for LRFS. Patients treated by radiotherapy alone had more residual disease following the course of treatment compared to patients treated with the combined therapy; 69% vs. 28%, respectively. Conclusion: Our results suggest that radiation alone was not an inferior treatment modality for CSS compared to the combined therapy for squamous cell carcinoma of the external auditory canal and middle ear. However, local failure after radiotherapy is the main issue that will require further improvement to gain optimal local control.

키워드

참고문헌

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