• 대한두경부종양학회지
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• 제20권1호
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• pp.19-23
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• 2004

Background and Objectives: Neck metastasis is one of the most important prognostic factor in head and neck squamous cell carcinoma. Recently, elective neck dissection has been widely accepted for accurate pathologic staging and elective treatment of neck. Occult metastasis rate of laryngeal cancer varies widely depending upon authors. To evaluate the rate and characteristics of occult metastasis and efficacy of the elective neck dissection in clinical N0 laryngeal cancer, we performed this study. Materials and Method: Seventy two patients (supraglottic cancer: 19 cases, glottic cancer: 53 cases) who underwent surgery for laryngeal cancer as an initial treatment from 1993 to 2002 were evaluated. All was underwent elective neck dissection at the time of surgery for the primary treatment. The record of patients and pathologic report were reviewed retrospectively. Results: Occult metastasis rate of supraglottic and glottic cancer were 42.1% (8/19) and 9.4% (5/53), respectively. According to T stage, the occult meastasis of supraglottic and glottic cancer was 20%, 0% in T1, 36.4%, 0% in T2, 100%, 40% in T2, 100%, 20% in T4, respectively. Occult metastasis was mostly confined within level II (69.2%), III (76.9%), IV (23.1%). Conclusion: Based on ours results, elective neck dissection might be needed in treating of clinically N0 all supraglottic cancer and advanced T3, T4 glottic cancer.

• 대한두경부종양학회지
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• 제10권2호
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• pp.178-184
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• 1994

저자들은 1985년부터 1992년까지 연세대학교 의과대학 영동세브란스병원에서 치료한 병기 $T_1$성문암 환자 30례를 대상으로 임상적 분석을 시행하여 다음과 같은 결과를 얻었다. 1) 병기 $T_1$성문암의 경우 남여의 비는 29:1로 남자가 대부분이었으며, 60대에 호발하였다. 2) 전례가 편평상피암이었으며 조직학적 분화도가 좋았던 경우가 13례, 중간 분화도이었던 경우가 17례이었다. 3) 초치료로 방사선치료를 한 경우 25.9%에서 재발이 있었으며, 부분후두적출술을 시행한 2례중 1례에서 재발이 있었다. 4) 재발한 경우, 전례에서, 원발부위의 재발이었고 경부재발이 동반된 경우가 1례있었으며, 1년이내 재발이 흔하였다. 5)원발부위 재발의 경우 전연합(anterior commissure)에서 재발이 빈발하였다. 6) 5년 생존율은 81.5%로 이는 병기간, 병리조직학적으로 유의한 차이는 없었다.

• Radiation Oncology Journal
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• 제15권4호
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• pp.315-319
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• 1997

목적 : 조기성문암의 치료시 근치적방사선치료의 효율성과 치료실패시 구제술 시행의 효과를 알아보고자 하였다. 대상 및 방법 : 1989년 6월부터 1994년 12월 사이에 경상대학교병원에서 방사선치료를 시행 받은 18명의 T1N0M0과 5명의 T2N0M0을 포함하는 23명의 조기성문암 환자에 대하여 후향적분석을 시행하였다. 모든 환자가 남자이었고, 연령분포는 33세부터 70세로 중앙값은 57세이었다. 추적조사기간의 중앙값은 46개월이었고, $100\%$의 환자에서 추적이 가능하였다. 결과 : 전체환자의 5년 생존율은 $84.3\%$이었고, 병기에 따라서 T1 $94.4\%,\;T2\;53.3\%$이었다. 전체환자의 5년 국소치유율은 $67.8\%$이었고, 병기에 따라서 T1 $70.0\%,\;T2\;60.0\%$이었다. 치료실패한 환자 8명 중 5명에서 구제술이 시행되었다. 구제술후 5년 국소치유율은 T1 $85.6\%,\;T2\;80.0\%$이었다. 결론 : 병기 T1, T2의 조기성문암의 치료시 우선 근치적 방사선치료를 시행하고, 치료실패시구제술을 시행하는 것이 높은 국소치유율과 성대보존율을 기대할 수 있는 효과적인 치료방법이라고 판단된다.

• 대한두경부종양학회지
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• 제29권2호
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• pp.58-61
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• 2013

Early glottic cancer can be effectively treated with surgery or radiotherapy showing the comparable treatment results. Since radiation therapy may be better in terms of voice preservation, it tends to be preferred in early glottic cancer. Most common recurrence site is glottis after radiation therapy and complete remission of glottic primary site followed by local recurrence limited to neck is very rare. The authors are reporting a patient with regional recurrence of central neck lymph nodes after radiation therapy for T1a glottic cancer.

• 대한두경부종양학회지
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• 제4권1호
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• pp.29-34
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• 1988

Radiation therapy is generally considered to be the treatment of choice in $T_1$ glottic cancer, maninly because of preservation of voice function and its local control rate is comparable to that of surgery. Failures from radiation therapy can be ultimately salvaged by surgery. A retrospective analysis of the treatment of 25 patients with $T_1$ glottic cancer seen at the Yonsei Cancer Center from 1980 to 1984 is presented. Radiation dose to the target volume varied from 6400 to 7000 cGy in 6-7 weeks. The local control rate is 84%. Four patients had primary failure and three of these patients had salvage surgery. Of the 3 patients who had salvage surgery, 2 were cured and aonther one was died with progression of the disease. 5-year acturial and disease free survival rate are 91.1%,78.0% respectively.

• 대한두경부종양학회지
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• 제12권1호
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• pp.26-31
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• 1996

Radiation therapy in T1 glottic cancer offers an excellent cure rate with preservation of voice. From 1983 to 1992 eighty nine patients with TNM staged T1N0M0 invasive squamous cell carcinoma of the glottis were treated at the Dept. of Radiation Oncology, Yonsei Cancer Center, Yonsei University. There were 84 men and 5 women with median age of 59 years. All patients were treated either with Co-60 teletherapy unit or 4MV linear accelerator with an median dose of 6400 cGy(6000-7000 cGy), 200 cGy per day, 5 days in a week. Fourteen local failures have been observed and the median time to local recurrence was 17 months. There were no nodal failure without local recurrence or distant metastases. The 5 year local control rate was 84.3%. The 5 year actuarial surivival rate and the 5 year disease free survival rate were 89.2%, 87.5%, respectively. The 5 year actuarial survival rate and the 5 year disease free survival rate of the nineteen patients with anterior commissure involvement were 77.8% and 74.5% which were lower than those of seventy patients without anterior commissure involvement(91.6%, 90.6%)(p < 0.05). Among the several influencing factors, anterior commissure involvement was the significant prognostic foctor. Final local control rate, taking into account the salvage surgery, was 89.9% at 5 years.

• 대한두경부종양학회지
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• 제21권2호
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• pp.132-138
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• 2005

Purpose: The purpose of this study was to establish general guidelines for the treatment of patients with early glottic cancer(T1-2N0M0), by assessing the role of primary radiation therapy and by analyzing the tumor-related and treatment-related factors that influence treatment results. We also studied the results of hypofractionated radiation therapy for early glottic cancer. Material and Methods: This retrospective study comprised 48 patients who suffered from early glottic cancer and were treated by primary radiotherapy at Inha University Hospital, between May 1997 and October 2004. T-stage distribution showed 38 patients as T1 and 10 patients as stage T2. Thirty-eight patients underwent hypofractionated radiotherapy using a 6 MY photon beam, a total tumor dose of 63Gy, in 5 weekly fractions of 2.25Gy, with an overall radiation treatment time of 38 days. Ten patients in the T2 stage tolerated a total dose of 63-72 Gy(median 68.4Gy) in 5 weekly fractions of 1.8-2.0Gy, with an overall radiation treatment time of 40-87 days(median 51 days). All patients were followed up for at least 3 years. Univariate and multivariate analyses were performed to identify the prognostic factors affecting the treatment results. Result: The 5-year survival rate was 92% for all patients, 94% for T1 patients and 91% for T2 patients. The local control rate was 93.5% for all patients, 95% for T1 and 92.2% for T2 patients. Three patients suffered a relapse following radiotherapy, and underwent subsequent salvage surgery. We included T-stage, tumor location, total radiation dose, field size and overall radiation treatment time as potential prognostic factors. Only T-stage was found to be statistically significant in the univariate analysis, but in the multivariate analysis, it was not found to be significant. Conclusion: High curative and voice preservation rates were obtained with hypofractionated radiotherapy. Further study with a larger number of patients is needed to determine the prognostic factors affecting treatment results.

• Radiation Oncology Journal
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• 제38권1호
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• pp.11-17
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• 2020

Purpose: Definitive radiotherapy remains a primary treatment option for early stage glottic cancer. Intensity-modulated radiation therapy (IMRT) has emerged as the standard treatment technique for advanced head and neck cancers, whereas three-dimensional conformal radiotherapy (3D-CRT) has remained standard for early glottic cancers. We used the National Cancer Database (NCDB) to identify predictors of IMRT use and effect on outcome in these patients. Materials and Methods: We queried the NCDB from 2004-2015 for squamous cell carcinoma of the glottic larynx staged Tis-T2N0 treated with radiation alone. Logistic regression was used to identify predictors of IMRT. Cox regression was used to identify factors predictive of overall survival. Propensity matching was conducted to account for indication bias. Results: We identified 15,627 patients, of which 11% received IMRT. IMRT use rose from 2% in 2004 to 16% in 2015. Predictors of IMRT include: increased comorbidity, T2 stage, urban location, chemotherapy, treatment at an academic center, and later treatment year. Predictors of improved survival were female gender, higher income, lower stage, no chemotherapy, academic facility, and more remote year. There was no difference in survival between 3D-CRT and IMRT across all stages. Conclusions: The rate of IMRT use for early stage glottic laryngeal cancer has increased over time. There was no difference in outcome in patients receiving IMRT versus 3D-CRT across the cohort.

• Radiation Oncology Journal
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• 제8권1호
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• pp.51-57
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• 1990

1979년 3월부터 1984년 8월 사이에 서울대학교병원에서 방사선치료를 받은 31명의 TINOMO와 17명의 T2NOMO를 포함하는 48명의 초기성문암 환자에 대한 후향적 조사분석을 시행하였다. 대상 환자들에 대한 추적조사기간의 중간값은 67개월이었으며 (범위 : 34개월$\~$126개월), $85.4\%$의 환자에서 5년이상 추적이 가능하였다. 전체 환자군의 5년 생존율 및 무병 생존율은 각각 $83.2\%$ 및 $69.4\%$였다. T1 병기환자군의 5년 생존율 및 무병생존율은 각각 $87.1\%$ 및 $76.0\%$였으며, T2 병기 환자군에서는 각각 $76.5\%$ 및 $58.2\%$였다. 초기 성문암의 방사선치료에 있어서의 치료실패의 원인, 선량-반응 관계, 이차성 악성종양의 발현 및 보다 좋은 치료성 적을 얻기 위한 제언 등에 대한 분석 및 토론을 하였다.

• 대한두경부종양학회지
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• 제4권1호
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• pp.41-51
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• 1988

To evaluate the result of radiation therapy for twenty years experience, a total of 115 cases of pathologically proven glottic carcinoma had been analyzed according tot survival respectively. All the patients had been treated with radiation therapy in curative intent using Co-60 teletherapy machine. The results are as follows: 1) Accoridng to sex, 5YSR & 10YSR were 58.7% and 50.4% in male patients, and 80.0% & 72.0% in female. 2) According to T staging, 5YSR & 10YSR were 83.4% & 83.4% in T1, 69.2% & 60.0% in T2, 34.3% & 21.8% in T3, 32.0% & 0% in T4. 3) According to N staging, 5YSR & 10YSR were 63.8% & 59.2% in node-negative groups, and 30.7% & 15.4% in node-positive groups. 4) According to the histologic grade, 5YSR & 10YSR were 66.8% & 57.6% in G1, 61.3% 54.3% in G2, and 35.0% 35.0% in G3. 5) According to AJC staging, 5YSR & 10YSR were 83.4%% 83.4% in stage I, 72.0% & 62.7% in stage II, 36.8% & 28.3% in stage III, and 14.3% & 7.1% in stage IV. 6) In summary, 5YSR & 10YSR wre 60.4% & 52.8% in glottic carcinoma.