RADPLATによる喉頭機能温存治療
「はじめに」 喉頭扁平上皮癌の発生頻度は低くなりつつあるが, 生存率は過去10数年で低下しつつある. この要因として喉頭全摘術を含めた根治的外科手術から, 喉頭臓器, 機能温存を重視した放射線治療, 化学放射線治療へと治療が変化してきたためと考えられる. 局所進行喉頭癌に対して推奨される根治治療は喉頭全摘出術後の(化学)放射線治療だが, これにより呼吸, 発声, 嗅覚機能に影響を与え, QOLの低下を招く. そのため多くの施設では生存率の低下にも関わらず, 臓器, 機能温存を目的とした強度の高い化学放射線治療を行っている. しかし, この化学放射線治療は遷延する喉頭浮腫, 粘膜線維化, 喉頭知...
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| Published in | 喉頭 Vol. 31; no. 2; pp. 69 - 74 |
|---|---|
| Main Authors | , , , , , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
日本喉頭科学会
01.12.2019
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0915-6127 2185-4696 |
| DOI | 10.5426/larynx.31.69 |
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| Abstract | 「はじめに」 喉頭扁平上皮癌の発生頻度は低くなりつつあるが, 生存率は過去10数年で低下しつつある. この要因として喉頭全摘術を含めた根治的外科手術から, 喉頭臓器, 機能温存を重視した放射線治療, 化学放射線治療へと治療が変化してきたためと考えられる. 局所進行喉頭癌に対して推奨される根治治療は喉頭全摘出術後の(化学)放射線治療だが, これにより呼吸, 発声, 嗅覚機能に影響を与え, QOLの低下を招く. そのため多くの施設では生存率の低下にも関わらず, 臓器, 機能温存を目的とした強度の高い化学放射線治療を行っている. しかし, この化学放射線治療は遷延する喉頭浮腫, 粘膜線維化, 喉頭知覚低下を来し, その結果, 呼吸, 嚥下機能を悪化させることがしばしば見受けられる. ForastiereらはRTOG91-11試験で進行喉頭癌の喉頭温存治療は化学放射線治療であるとし, この試験は喉頭温存治療のランドマークとなっている. |
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| AbstractList | 「はじめに」 喉頭扁平上皮癌の発生頻度は低くなりつつあるが, 生存率は過去10数年で低下しつつある. この要因として喉頭全摘術を含めた根治的外科手術から, 喉頭臓器, 機能温存を重視した放射線治療, 化学放射線治療へと治療が変化してきたためと考えられる. 局所進行喉頭癌に対して推奨される根治治療は喉頭全摘出術後の(化学)放射線治療だが, これにより呼吸, 発声, 嗅覚機能に影響を与え, QOLの低下を招く. そのため多くの施設では生存率の低下にも関わらず, 臓器, 機能温存を目的とした強度の高い化学放射線治療を行っている. しかし, この化学放射線治療は遷延する喉頭浮腫, 粘膜線維化, 喉頭知覚低下を来し, その結果, 呼吸, 嚥下機能を悪化させることがしばしば見受けられる. ForastiereらはRTOG91-11試験で進行喉頭癌の喉頭温存治療は化学放射線治療であるとし, この試験は喉頭温存治療のランドマークとなっている. |
| Author | 栗田, 卓 宮田, 祐作 小野, 剛治 田中, 法瑞 村木, 宏一郎 末吉, 慎太郎 麻生, 丈一朗 千年, 俊一 辻, 千代子 深堀, 光緒子 安陪, 等思 梅野, 博仁 |
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| DOI | 10.5426/larynx.31.69 |
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| References | 15）Chevalier D, Laccourreye O, Brasnu D et al : Cricohyoidoepiglottopexy for glottic carcinoma with fixation or impaired motion of the true vocal cord : 5-year oncologic results with 112 patients. Ann Otol Rhinol Laryngol 106 : 364-369, 1997. 21）Al-Mamgani A, Tans L, van Rooij P et al : A single-institutional experience of 15 years of treating T3 laryngeal cancer with primary radiotherapy, with or without chemotherapy. Int J Radiat Oncol Biol Phys 83 : 1000-1006, 2012. 19）Al-Mamgani A, van Rooij PH, Woutersen DP et al : Radiotherapy for T1-2N0 glottic cancer : a multivariate analysis of predictive factors for the long-term outcome in 1050 patients and a prospective assessment of quality of life and voice handicap index in a subset of 233 patients. Clin Otolaryngol 38 : 306-312, 2013. 18）Fuller CD, Mohamed AS, Garden AS et al : Long-term outcomes after multidisciplinary management of T3 laryngeal squamous cell carcinomas : Improved functional outcomes and survival with modern therapeutic approaches. Head Neck 38 : 1739-1751, 2016. 13）Zhou J, Zhou L, Tao L et al : Oncologic outcomes of surgical treatment for T3 glottic laryngeal squamous cell carcinoma. Head Neck 40 : 1734-1742, 2018. 22）Timmermans AJ, de Gooijer CJ, Hamming-Vrieze O et al : T3-T4 laryngeal cancer in The Netherlands Cancer Institute ; 10-year results of the consistent application of an organ-preserving /-sacrificing protocol. Head Neck 37 : 1495-1503, 2015. 26）Yoshizaki T, Kondo S, Wakisaka N et al : Concurrent intra-arterial chemotherapy and radiotherapy for advanced laryngeal cancer. Ann Otol Rhinol Laryngol 118 : 172-178, 2009. 2）Adelstein DJ, Lavertu P, Saxton JP et al : Mature results of a phase Ⅲ randomized trial comparing concurrent chemoradiotherapy with radiation therapy alone in patients with stage Ⅲ and Ⅳ squamous cell carcinoma of the head and neck. Cancer 88 : 876-883, 2000. 25）横山純吉，古川 仭：進行声門癌（T3，4）症例に対する超選択的動注療法による喉頭温存療法の検討．喉頭 18：84-88，2006. 12）Agrawal N, Ha PK : Management of early-stage laryngeal cancer. Otolaryngol Clin N Am 41 : 757-769, 2008. 20）Hinerman RW, Mendenhall WM, Morris CG et al : T3 and T4 true vocal cord squamous arcinomas treated with external beam irradiation : a single institution’s 35-year experience. Am J Clin Oncol 30 : 181-185, 2007. 17）Timme DW, Jonnalagadda S, Patel R et al : Treatment selection for T3/T4a laryngeal cancer : chemoradiation versus primary surgery. Ann Otol Rhinol Laryngol 124 : 845-851, 2015. 24）Bhateja P, Ward MC, Hunter GH et al : Impaired vocal cord mobility in T2N0 glottic carcinoma : Suboptimal local control with Radiation alone. Head Neck 38 : 1832-1836, 2016. 11）Kimura K, Itoh Y, Okada T et al : Study Protocol : Prospective Study of Concurrent Chemoradiotherapy with S-1 and Hypofractionated Radiotherapy for Outpatients with Early Glottic Squamous Cell Carcinomas. Asian Pac J Cancer Prev 19 : 1195-1199, 2018. 5）Megwalu UC, Sikora AG : Survival outcomes in advanced laryngeal cancer. JAMA Otolaryngol Head Neck Surg 140 : 855-860, 2014. 7）Robbins KT, Storniolo AM, Kerber C et al : Rapid superselective high-dose cisplatin infusion for advanced head and neck malignancies. Head Neck 14 : 364-371, 1992. 8）Rasch CR, Hauptmann M, Schornagel J et al : Intra-arterial versus intravenous chemoradiation for advanced head and neck cancer : Results of a randomized phase 3 trial. Cancer 116 : 2159-2165, 2010. 10）小野剛治，千年俊一，田中法瑞ほか：下咽頭癌に対する経口的レーザー切除術と局所進行喉頭癌に対する選択的動注化学放射線治療．頭頸部癌 in press. 3）Bonner J, Giralt J, Harari P et al : Cetuximab and Radiotherapy in Laryngeal Preservation for Cancers of the Larynx and Hypopharynx : A Secondary Analysis of a Randomized Clinical Trial. AMA Otolaryngol Head Neck Surg 142 : 842-849, 2016. 16）Canis M, Martin A, Ihler F et al : Transoral laser microsurgery in treatment of pT2 and pT3 glottic laryngeal squamous cell carcinoma-results of 391 patients. Head Neck 36 : 859-866, 2014. 9）小野剛治，千々和秀記，梅野博仁ほか：喉頭癌に対する選択的動注化学放射線治療．喉頭 21：71-77，2009. 4）NCCN Clinical Practice Guidelines in Oncology. Head and neck cancers. Version 2, 2018, 07/20/18. National Comprehensive Cancer Network, 2018 28）Lambert L, Fortin B, Soulières D et al : Organ preservation with concurrent chemoradiation for advanced laryngeal cancer : are we succeeding? Int J Radiat Oncol Biol Phys 76 : 398-402, 2010. 27）Robbins KT, Kumar P, Harris J et al : Supradose intra-arterial cisplatin and concurrent radiation therapy for the treatment of stageⅣ head and neck squamous cell carcinoma is feasible and efficacious in a multi-institutional setting : results of Radiation Therapy Oncology Group Trial 9615. J Clin Oncol 23 : 1447-1454, 2005. 1）Steuer CE, El-Deiry M, Parks JR et al : An update on larynx cancer. CA Cancer J Clin 67 : 31-50, 2017. 23）Gorphe P, Matias M, Even C et al : Laryngo-esophageal dysfunction-free survival in a preservation protocol for T3 laryngeal squamous-cell carcinoma. Anticancer Res 36 : 6625-6630, 2016. 14）Ampil FL, Nathan CO, Lian TS et al : Total laryngectomy and T3-T4 laryngeal cancer without other adverse histopathology. Otolaryngol Head Neck Surg 136 : 296-300, 2007. 6）Forastiere AA, Goepfert H, Maor M et al : Concurrent chemotherapy and radiotherapy for organ preservation in advanced laryngeal cancer. N Engl J Med 349 : 2091-2098, 2003. |
| References_xml | – reference: 10）小野剛治，千年俊一，田中法瑞ほか：下咽頭癌に対する経口的レーザー切除術と局所進行喉頭癌に対する選択的動注化学放射線治療．頭頸部癌 in press. – reference: 17）Timme DW, Jonnalagadda S, Patel R et al : Treatment selection for T3/T4a laryngeal cancer : chemoradiation versus primary surgery. Ann Otol Rhinol Laryngol 124 : 845-851, 2015. – reference: 19）Al-Mamgani A, van Rooij PH, Woutersen DP et al : Radiotherapy for T1-2N0 glottic cancer : a multivariate analysis of predictive factors for the long-term outcome in 1050 patients and a prospective assessment of quality of life and voice handicap index in a subset of 233 patients. Clin Otolaryngol 38 : 306-312, 2013. – reference: 12）Agrawal N, Ha PK : Management of early-stage laryngeal cancer. Otolaryngol Clin N Am 41 : 757-769, 2008. – reference: 24）Bhateja P, Ward MC, Hunter GH et al : Impaired vocal cord mobility in T2N0 glottic carcinoma : Suboptimal local control with Radiation alone. Head Neck 38 : 1832-1836, 2016. – reference: 21）Al-Mamgani A, Tans L, van Rooij P et al : A single-institutional experience of 15 years of treating T3 laryngeal cancer with primary radiotherapy, with or without chemotherapy. Int J Radiat Oncol Biol Phys 83 : 1000-1006, 2012. – reference: 20）Hinerman RW, Mendenhall WM, Morris CG et al : T3 and T4 true vocal cord squamous arcinomas treated with external beam irradiation : a single institution’s 35-year experience. Am J Clin Oncol 30 : 181-185, 2007. – reference: 5）Megwalu UC, Sikora AG : Survival outcomes in advanced laryngeal cancer. JAMA Otolaryngol Head Neck Surg 140 : 855-860, 2014. – reference: 18）Fuller CD, Mohamed AS, Garden AS et al : Long-term outcomes after multidisciplinary management of T3 laryngeal squamous cell carcinomas : Improved functional outcomes and survival with modern therapeutic approaches. Head Neck 38 : 1739-1751, 2016. – reference: 2）Adelstein DJ, Lavertu P, Saxton JP et al : Mature results of a phase Ⅲ randomized trial comparing concurrent chemoradiotherapy with radiation therapy alone in patients with stage Ⅲ and Ⅳ squamous cell carcinoma of the head and neck. Cancer 88 : 876-883, 2000. – reference: 11）Kimura K, Itoh Y, Okada T et al : Study Protocol : Prospective Study of Concurrent Chemoradiotherapy with S-1 and Hypofractionated Radiotherapy for Outpatients with Early Glottic Squamous Cell Carcinomas. Asian Pac J Cancer Prev 19 : 1195-1199, 2018. – reference: 6）Forastiere AA, Goepfert H, Maor M et al : Concurrent chemotherapy and radiotherapy for organ preservation in advanced laryngeal cancer. N Engl J Med 349 : 2091-2098, 2003. – reference: 15）Chevalier D, Laccourreye O, Brasnu D et al : Cricohyoidoepiglottopexy for glottic carcinoma with fixation or impaired motion of the true vocal cord : 5-year oncologic results with 112 patients. Ann Otol Rhinol Laryngol 106 : 364-369, 1997. – reference: 23）Gorphe P, Matias M, Even C et al : Laryngo-esophageal dysfunction-free survival in a preservation protocol for T3 laryngeal squamous-cell carcinoma. Anticancer Res 36 : 6625-6630, 2016. – reference: 28）Lambert L, Fortin B, Soulières D et al : Organ preservation with concurrent chemoradiation for advanced laryngeal cancer : are we succeeding? Int J Radiat Oncol Biol Phys 76 : 398-402, 2010. – reference: 7）Robbins KT, Storniolo AM, Kerber C et al : Rapid superselective high-dose cisplatin infusion for advanced head and neck malignancies. Head Neck 14 : 364-371, 1992. – reference: 4）NCCN Clinical Practice Guidelines in Oncology. Head and neck cancers. Version 2, 2018, 07/20/18. National Comprehensive Cancer Network, 2018 – reference: 13）Zhou J, Zhou L, Tao L et al : Oncologic outcomes of surgical treatment for T3 glottic laryngeal squamous cell carcinoma. Head Neck 40 : 1734-1742, 2018. – reference: 16）Canis M, Martin A, Ihler F et al : Transoral laser microsurgery in treatment of pT2 and pT3 glottic laryngeal squamous cell carcinoma-results of 391 patients. Head Neck 36 : 859-866, 2014. – reference: 3）Bonner J, Giralt J, Harari P et al : Cetuximab and Radiotherapy in Laryngeal Preservation for Cancers of the Larynx and Hypopharynx : A Secondary Analysis of a Randomized Clinical Trial. AMA Otolaryngol Head Neck Surg 142 : 842-849, 2016. – reference: 27）Robbins KT, Kumar P, Harris J et al : Supradose intra-arterial cisplatin and concurrent radiation therapy for the treatment of stageⅣ head and neck squamous cell carcinoma is feasible and efficacious in a multi-institutional setting : results of Radiation Therapy Oncology Group Trial 9615. J Clin Oncol 23 : 1447-1454, 2005. – reference: 8）Rasch CR, Hauptmann M, Schornagel J et al : Intra-arterial versus intravenous chemoradiation for advanced head and neck cancer : Results of a randomized phase 3 trial. Cancer 116 : 2159-2165, 2010. – reference: 9）小野剛治，千々和秀記，梅野博仁ほか：喉頭癌に対する選択的動注化学放射線治療．喉頭 21：71-77，2009. – reference: 1）Steuer CE, El-Deiry M, Parks JR et al : An update on larynx cancer. CA Cancer J Clin 67 : 31-50, 2017. – reference: 22）Timmermans AJ, de Gooijer CJ, Hamming-Vrieze O et al : T3-T4 laryngeal cancer in The Netherlands Cancer Institute ; 10-year results of the consistent application of an organ-preserving /-sacrificing protocol. Head Neck 37 : 1495-1503, 2015. – reference: 14）Ampil FL, Nathan CO, Lian TS et al : Total laryngectomy and T3-T4 laryngeal cancer without other adverse histopathology. Otolaryngol Head Neck Surg 136 : 296-300, 2007. – reference: 25）横山純吉，古川 仭：進行声門癌（T3，4）症例に対する超選択的動注療法による喉頭温存療法の検討．喉頭 18：84-88，2006. – reference: 26）Yoshizaki T, Kondo S, Wakisaka N et al : Concurrent intra-arterial chemotherapy and radiotherapy for advanced laryngeal cancer. Ann Otol Rhinol Laryngol 118 : 172-178, 2009. |
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| SubjectTerms | シスプラチン 喉頭温存 喉頭癌 選択的動注化学放射線治療 |
| Title | RADPLATによる喉頭機能温存治療 |
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