Impact of small doses of chemotherapy for patients with early glottic carcinoma / 中国生化药物杂志

ABSTRACT

Objective To investigate the curative effect of surgery,radiotherapy and photodynamic therapy combined with chemotherapy on early glottic carcinoma and prognostic factors.Methods Clinical data of 122 cases of early glottic carcinoma with Tis ~T2 N0 M0 were analyzed retrospectively.Small doses of chemotherapy applied to single drug cisplatin (according to the surface area of 50 mg/m2 ).83 patients underwent surgical treatments combined with chemotherapy,20 cases accepted radiotherapy combined with chemotherapy and 19 cases accepted photodynamic therapy combined with chemotherapy. Results The 3 and 5 years overall survival rates (overall survival,OS ) of surgery group,radiotherapy group and photodynamic group were 92.7%,93.8% and 89.5%,89.5% and 84.4% ,89.5%,respectively.The 2-year disease free survival rate (disease-freesurvival,DFS)were 87.6%,79.4%,78.6%,respectively.The 2-year local control rate(local control,LC)were 91.9%,84.4%,83.0%, respectively.27 cases suffered from tumor recurrence or metastasis,15 cases in the surgery group,3 cases in the radiotherapy group and 5 cases in the photodynamic group,among them 19 patients accepted salvage surgery.Multifactor retrospective analysis indicated anterior commissure invasion (P=0.047),clinical stage(P =0.018)and KPS score before treatment(P =0.001)were independent adverse prognostic factors for OS.Anterior commissure invasion(P=0.027)and differentiation degree(P=0.041)were adverse prognostic factors for DFS.Anterior commissure invasion was also poor prognostic features for LC(P=0.047).Conclusion Radiotherapy and photodynamic therapy combined with chemotherapy may be the first or very important treatment on early stage glottic squamous cell cancer(Tis ~T2N0M0 ).High preservation rate of laryngeal function with radiotherapy and photodynamic therapy combined with chemotherapy can significantly improved quality of life of patients.Curative effect of three groups was similar,and three kinds of curative methods achieved good effect.KPS score before treatment,glottis impair and differentiation degree were the main adverse prognostic factors for early stage glottic carcinoma.