Patients were eligible if they had biopsy-proven, pre- viously untreated stage III or IV (according to the staging system of the American Joint Commission onCancer)squamous-cellcarcinomaoftheglottic or supraglottic larynx, the surgical treatment of which would require total laryngectomy. Patients
with a stage T1 primary tumor (defined as tumor limited to one subsite of the supraglottis or limited tothevocalcords,withnormalvocal-cordmobility, according to the tumor–node–metastasis [TNM] staging system) or with large-volume stage T4 dis- ease (defined as a tumor penetrating through the cartilage or extending more than 1 cm into the base of the tongue) were not eligible. The disease had to be considered curable with surgery and postopera- tive radiotherapy. A Karnofsky performance score of at least 60 (on a scale from 0 to 100, with higher scores indicating better performance and with a score of 60 indicating that the patient requires occa- sional assistance but is able to care for most of his or her own needs) was required. To be eligible, pa- tients also had to have a white-cell count of at least 3500 per cubic millimeter, a platelet count of at least 100,000 per cubic millimeter, a normal serum calci- um level, and a creatinine clearance of at least 50 ml per minute. All the patients gave written informed consent in accordance with institutional guidelines.
Pretreatment staging, involving laryngoscopy, measurement of the tumor, and high-resolution computed tomographic (CT) scanning of the pri- mary tumor and the neck, was performed within four weeks before entry into the study. To rule out synchronous primary cancers, either CT imaging of the chest and barium esophagography or pan- endoscopy (i.e., esophagoscopy and bronchoscopy) was performed. Imaging was performed as clinical- ly indicated to rule out metastatic disease.
Patients were eligible if they had biopsy-proven, pre- viously untreated stage III or IV (according to the staging system of the American Joint Commission onCancer)squamous-cellcarcinomaoftheglottic or supraglottic larynx, the surgical treatment of which would require total laryngectomy. Patients
with a stage T1 primary tumor (defined as tumor limited to one subsite of the supraglottis or limited tothevocalcords,withnormalvocal-cordmobility, according to the tumor–node–metastasis [TNM] staging system) or with large-volume stage T4 dis- ease (defined as a tumor penetrating through the cartilage or extending more than 1 cm into the base of the tongue) were not eligible. The disease had to be considered curable with surgery and postopera- tive radiotherapy. A Karnofsky performance score of at least 60 (on a scale from 0 to 100, with higher scores indicating better performance and with a score of 60 indicating that the patient requires occa- sional assistance but is able to care for most of his or her own needs) was required. To be eligible, pa- tients also had to have a white-cell count of at least 3500 per cubic millimeter, a platelet count of at least 100,000 per cubic millimeter, a normal serum calci- um level, and a creatinine clearance of at least 50 ml per minute. All the patients gave written informed consent in accordance with institutional guidelines.
Pretreatment staging, involving laryngoscopy, measurement of the tumor, and high-resolution computed tomographic (CT) scanning of the pri- mary tumor and the neck, was performed within four weeks before entry into the study. To rule out synchronous primary cancers, either CT imaging of the chest and barium esophagography or pan- endoscopy (i.e., esophagoscopy and bronchoscopy) was performed. Imaging was performed as clinical- ly indicated to rule out metastatic disease.
การแปล กรุณารอสักครู่..
![](//thimg.ilovetranslation.com/pic/loading_3.gif?v=b9814dd30c1d7c59_8619)