Intervention Review

Radiotherapy versus open surgery versus endolaryngeal surgery (with or without laser) for early laryngeal squamous cell cancer

  1. Paola Dey1,*,
  2. Derrick Arnold2,
  3. Richard Wight3,
  4. Charles G Kelly4,
  5. Kenneth McKenzie5

Editorial Group: Cochrane Ear, Nose and Throat Disorders Group

Published Online: 21 JAN 2009

Assessed as up-to-date: 30 SEP 2009

DOI: 10.1002/14651858.CD002027

Database Title

Additional Information

How to Cite

Dey P, Arnold D, Wight R, Kelly CG, McKenzie K. Radiotherapy versus open surgery versus endolaryngeal surgery (with or without laser) for early laryngeal squamous cell cancer. Cochrane Database of Systematic Reviews 2002, Issue 2. Art. No.: CD002027. DOI: 10.1002/14651858.CD002027.

Author Information

  1. 1

    University of Central Lancashire, Lancashire School of Health and Postgraduate Medicine, Preston, UK

  2. 2

    Christie Hospital NHS Trust, Centre for Cancer Epidemiology, Manchester, UK

  3. 3

    North Riding Infirmary, Department of ENT Surgery, Middlesborough, Cleveland, UK

  4. 4

    Newcastle General Hospital, Northern Centre for Cancer Treatment, Newcastle upon Tyne, UK

  5. 5

    Glasgow Royal Infirmary, Department of ENT Surgery, Glasgow, UK

*Paola Dey, Lancashire School of Health and Postgraduate Medicine, University of Central Lancashire, Harrington Building, Preston, PR1 2HE, UK. MPDey@uclan.ac.uk.

Publication History

  1. Publication Status: New search for studies and content updated (no change to conclusions)
  2. Published Online: 21 JAN 2009

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Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

This is an update of a Cochrane Review first published in The Cochrane Library in Issue 2, 2002 and previously updated in 2004 and 2007.

Radiotherapy, open surgery and endolaryngeal excision (with or without laser) are all accepted modalities of treatment for early stage glottic cancer. Case series suggest that they confer similar survival advantage. Opinions on optimal therapy vary across disciplines and between countries.

Objectives

To compare the effectiveness of open surgery, endolaryngeal excision (with or without laser) and radiotherapy in the management of early glottic laryngeal cancer.

Search methods

We searched the Cochrane Ear, Nose and Throat Disorders Group Trials Register; the Cochrane Central Register of Controlled Trials (CENTRAL); PubMed; EMBASE; CINAHL; Web of Science; BIOSIS Previews; Cambridge Scientific Abstracts; ISCTRN and additional sources for published and unpublished trials. The date of the most recent search was 1 October 2009, following previous searches in 2007, 2006, 2003 and 2002.

Selection criteria

Randomised controlled trials comparing open surgery, endolaryngeal resection and/or radiotherapy.

Data collection and analysis

Two authors independently assessed randomised controlled trials identified from the electronic searches for eligibility and methodological quality. All authors of the review discussed the results of these assessments.

Main results

Only one randomised controlled trial was identified which compared open surgery and radiotherapy among a substantial number of patients with early glottic laryngeal cancer.

Authors' conclusions

There is currently insufficient evidence to guide management decisions on the most effective treatment. Interpretation of the only large-scale randomised controlled trial comparing open surgery and radiotherapy in patients with early glottic cancer is limited because of concerns about the adequacy of treatment regimens and deficiencies in the reporting of the study design and analysis. Endolaryngeal resection of early glottic tumours is becoming more common. Two multicentre trials comparing endolaryngeal resection with radiotherapy are underway.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Radiotherapy versus open surgery versus endolaryngeal surgery (with or without laser) for early laryngeal squamous cell cancer

Cancer of the larynx (voice box) usually begins in the glottis (vocal cords) as a squamous cell cancer (cancer in the membranes). Most people survive these cancers when they get treatment early (before the cancer spreads further into the larynx and surrounding area). Options include radiotherapy, open surgery (through the neck) or, more commonly now, endolaryngeal excision (surgery reaching the throat via the mouth, sometimes with a laser). The review of trials found there is not enough evidence to show which form of treatment might be better for people with early stage laryngeal squamous cell carcinoma. Such evidence may come from new trials comparing radiotherapy and endolaryngeal excision, which have started.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

放射線治療、開放式手術、及喉內視鏡手術(有或無雷射)對於早期喉部鱗狀上皮癌的療效

放射線治療、開放式手術、及喉內視鏡切除手術(有或無雷射)對於早期聲門癌的病人都是可以接受的治療方式，彼此之間都有類似的存活率，也因此選擇合適的治療方式在不同國家不同地區也有不同的原則

目標

希望比較放射線治療、開放式手術、及喉內視鏡手術(有或無雷射)對於早期聲門癌病人的治療效果

搜尋策略

我們搜尋了以下資料庫： Cochrane Ear, Nose and Throat Disorders Group Trials Register, CENTRAL (The Cochrane Library, Issue 1, 2007) MEDLINE (from 1966 to April 2007) EMBASE (from 1980 to April 2007) CINAHL (from 1982 to April 2007)CancerLit (from 1963 to April 2007)

選擇標準

randomised controlled trials方式來比較放射線治療、開放式手術、及喉內視鏡手術的治療效果

資料收集與分析

兩個獨立的作者檢查搜尋可利用的數據資料，並對結果加以評估

主要結論

只有一項randomised controlled trial的研究在比較早期喉癌病人在開放式手術或放射線治療的成效

作者結論

目前沒有足夠的証據來決定何種治療為最有效之治療。唯一的一篇大型randomised controlled trial研究是在比較放射線治療及開放式手術的成效，但此篇論文缺少研究和資料分析的設計，所以不值得作為結論。近來內視鏡手術愈來愈常見，兩個multicentre trials比較內視鏡手術及放射線治療的成效仍在研究中

翻譯人

本摘要由國泰綜合醫院林建佑翻譯

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌

總結

目前沒有足夠的証據來決定何種方式來治療早期聲門癌最好，喉部鱗狀上皮癌通常自聲門開始，大部份存活的病人因為早期的治療(在癌細胞擴散至喉外前)，治療的方式包含放射線治療、開放式手術及最近比較常見的喉內視鏡手術(經口進入喉部，有時使用雷射)。這篇回顧性研究認為目前沒有足夠的証據何種治療對於早期聲門癌最好，也許兩個已經開始的新研究，比較放射線治療及內視鏡切除手術，可以給我們一些結果

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