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Titolo:
INTRAOPERATIVE BRACHYTHERAPY, LARYNGOPHARYNGOESOPHAGECTOMY, AND GASTRIC TRANSPOSITION FOR PATIENTS WITH RECURRENT HYPOPHARYNGEAL AND CERVICAL ESOPHAGEAL-CARCINOMA
Autore:
WILSON LD; CHUNG JY; HAFFTY BG; CAHOW EC; SASAKI CT; SON YH;
Indirizzi:
YALE UNIV,SCH MED,DEPT THERAPEUT RADIOL,HRT 136,333 CEDAR ST NEW HAVEN CT 06510 YALE UNIV,SCH MED,DEPT SURG NEW HAVEN CT 06510 YALE UNIV,SCH MED,DIV OTOLARYNGOL NEW HAVEN CT 00000
Titolo Testata:
The Laryngoscope
fascicolo: 10, volume: 108, anno: 1998,
pagine: 1504 - 1508
SICI:
0023-852X(1998)108:10<1504:IBLAG>2.0.ZU;2-A
Fonte:
ISI
Lingua:
ENG
Soggetto:
SQUAMOUS-CELL CARCINOMA; TOTAL PHARYNGOLARYNGECTOMY; PRESERVATION THERAPY; ADVANCED HEAD; NECK-CANCER; RADIOTHERAPY; IMPLANTS; SURGERY; RECONSTRUCTION; COMPLICATIONS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
25
Recensione:
Indirizzi per estratti:
Citazione:
L.D. Wilson et al., "INTRAOPERATIVE BRACHYTHERAPY, LARYNGOPHARYNGOESOPHAGECTOMY, AND GASTRIC TRANSPOSITION FOR PATIENTS WITH RECURRENT HYPOPHARYNGEAL AND CERVICAL ESOPHAGEAL-CARCINOMA", The Laryngoscope, 108(10), 1998, pp. 1504-1508

Abstract

Objective: To evaluate the role of laryngopharyngoesophagectomy (LPE), intraoperative I-125 brachytherapy (IOBT), and gastric transposition(GT) in patients with recurrent carcinoma involving the hypopharynx, or cervical esophagus. Methods: Between 1988 and 1994 a total of 21 patients were managed with LPE/IOBT/GT. All patients had documentation of recurrent disease at the hypopharynx or cervical esophagus and had previously been treated with external-beam radiation (EBRT) to a total median dose of 60 Gy. Median age was 67 years, with 17 male patients and four female. IOBT was performed in all cases with permanent I-125 implantation. Medical records were retrospectively reviewed. Overall survival, local control, and complications were evaluated. Median follow-up was 6 months. Results: The median activity of I-125 was 36 mCi, with a median dose of 80 Gy to the region at risk. Fifteen patients had lymph node dissections performed in conjunction with LPE, and 10 patients had nodal involvement on pathologic examination. Margins were microscopically positive in nine patients, and lymphvascular space invasion noted in 13. Actuarial survival at 1 and 3 years was 32% and 14%, respectively, with patients alive and with local control at 6, 24, 36, and 48 months (negative margins). Actuarial local control at 1 and 3 years was 63%. Complications included fistula in five patients, facial edema in four, protracted facial pain in two, cervical abscess in one, and mucosal hemorrhage in one. Conclusion: Patients with recurrent carcinoma of the hypopharynx or cervical esophagus after EBRT have an extremely poor prognosis. LPE, IOBT, and GT may provide very good local control for all candidates and prolonged survival for a small percentage of patients with an acceptable risk, profile.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 22/01/20 alle ore 06:55:01