| Objective:To study the prognosis of patients with supraglottic carcinoma with positive lymph nodes in area II and III after operation,and to evaluate the feasibility of selective high-risk area irradiation.Materials and methods:The complete clinical data of 181 patients with supraglottic laryngeal carcinoma treated in the Department of radiotherapy of the second hospital of Jilin University from February 2010 to March 2015 were retrospectively analyzed.Among them,100 patients were treated with whole neck prophylactic irradiation,81 patients were treated with selective high-risk area irradiation,i.e.II and III lymph drainage area.Results:The median follow-up time was 38.5 months.The five-year OS,PFS and NFS were 67.9%,58.01% and 64.6% respectively.There were 6 cases of lymph node recurrence,4 cases of local recurrence,8 cases of distant metastasis and 58 cases of death.However,no significant difference in recurrence was observed between the selective high-risk radiation group and the total neck prophylactic radiation group.OS,PFS,and NFS were 67.9% vs.68%,58.02% vs.58%,and 62.9% vs.66%,respectively,with P values of 0.9161,0.8916,and 0.7333.For the late toxicity of radiotherapy,the incidence of cervical fibrosis(2.47% vs 10%,P = 0.043)and the incidence of laryngeal mucosal injury(6.17% vs 24%,P = 0.001)were lower in the selective high-risk area group.Conclusion:1.There was no significant difference in OS,PFS and NFS between selective high-risk area irradiation and total neck prophylaxis irradiation in patients with supraglottic laryngeal carcinoma with positive lymph nodes in areas II and III;2.Compared with total neck prophylactic irradiation,selective high-risk area irradiation can reduce the damage of normal tissues,such as neck tissue fibrosis and throat mucosa injury.There was no significant difference in the incidence of radiation-induced oral mucositis,dry mouth,loss of taste and difficulty in opening mouth. |
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