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題名 | Minimal Benefit of Tonsillectomy in T1-T2 Tonsillar Squamous Cell Carcinoma Treated with Chemoradiotherapy= |
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作者 | Chao, Yun-ting; Wang, Ling-wei; Chu, Pen-yuan; Yang, Muh-hwa; Hsu, Yen-bin; Lee, Tsung-lun; Wang, Yi-fen; Tai, Shyh-kuan; |
期刊 | Journal of the Chinese Medical Association |
出版日期 | 20161000 |
卷期 | 79:10 2016.10[民105.10] |
頁次 | 頁570-576 |
分類號 | 416.894 |
語文 | eng |
關鍵詞 | Chemoradiotherapy; Quality of life; Surgical margin; Tonsillar squamous cell carcinoma; Tonsillectomy; |
英文摘要 | Background: Chemoradiotherapy (CRT) has become the mainstay of treatment for tonsillar squamous cell carcinoma (SCC). Pre-CRT tonsillectomy is frequently performed, mostly for small primary tumors (T1-T2). However, the benefits of pre-CRT tonsillectomy remain unclear. Methods: A retrospective review was performed in 66 patients with T1-T2 tonsillar SCCs treated by CRT from 1997 to 2009. The efficacy of preCRT tonsillectomy was analyzed with regard to oncological and functional outcomes. Results: Thirty patients (45.5%) received tonsillectomy (pre-CRT tonsillectomy group), and 36 patients (54.5%) did not (CRT group). Except for a trend toward more T1 cases (33.3% vs. 13.9%, p ¼ 0.061) and significantly less chemotherapy use (60% vs. 86.1%, p ¼ 0.016) in the pre-CRT tonsillectomy group, there were no differences between the two groups in terms of age, gender, N classification (nodal status), overall stage, radiation dose, duration, or technique. In the pre-CRT tonsillectomy group, eight cases (26.7%) achieved an adequate operative margin judged by the surgeon, and only one (12.5%) had a negative pathological margin. In long-term follow-up, there were no statistically significant differences between the two groups regarding local (93.3% vs. 91.7%, p ¼ 0.82) or regional control (93.3% vs. 94.4%, p ¼ 0.84). The pre-CRT tonsillectomy group did not have a better 5-year disease-specific survival rate (83.3% vs. 94.4%, p ¼ 0.177) or 5-year overall survival rate (70% vs. 94.4%, p ¼ 0.017). There were no differences in complications or functional results (feeding tube and tracheostomy dependence), and quality of life demonstrated no significant difference. Conclusion: Pre-CRT tonsillectomy contributes little to oncological and functional outcomes in patients with T1-T2 tonsillar SCC. |
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