OBJECTIVE: To evaluate the effects of radiotherapy and surgery on carcinoma of the middle ear. METHOD: A review of five published literatures was conducted according to defined selection criteria by the Review Manager 5.0 statistical software. RESULT: There were no systematic reviews or large-scale RCTs between radiotherapy and symptomatic treatment containing surgery and radiotherapy for carcinoma of the middle ear. CONCLUSION Radiotherapy and symptomatic treatment for carcinoma of the middle ear have no obvious differences. The radiotherapy is the first choice for the treatment of squamous cell carcinoma of the middle ear.
Carcinoma, Squamous Cell ; radiotherapy ; surgery ; therapy ; Ear Neoplasms ; radiotherapy ; surgery ; therapy ; Ear, Middle ; Humans ; Treatment Outcome

Nasopharyngeal cancer is a low differentiated squamous cell carcinoma, and the radiation therapy is the primary choice. It's 5 year survival rate may reach 64.4%, while 10.0% cases may suffer from the local recurrence. The salvage radiation or surgery is still the main choice for recurrent cases now. However the recurrent tumor become radiation insensitive and meanwhile, morbidity and mortality become higher. The experience of open salvage surgery on the recurrent radiation insensitive tumor had been proved safely, and the related morbidity and mortality are acceptable. Recently, the endoscopic salvage surgery has been developed, some preliminary experience has been obtained and the result looks promising. In this article, the pathobiological characteristics of the postradiation local recurrent nasopharyngeal cancer, the anatomy of nasopharyngus and related skull base area, especially the petroclival region and current situation of endonasal endoscopic salvage surgery were reviewed here. Basic principle of oncological surgery that endoscopic surgery should followed and possible endoscopic surgical approaches were proposed.
Carcinoma ; Carcinoma, Squamous Cell ; radiotherapy ; surgery ; Endoscopy ; Humans ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; radiotherapy ; surgery ; Neoplasm Recurrence, Local ; radiotherapy ; surgery ; Radiation Tolerance ; Salvage Therapy ; methods ; Skull Base ; Survival Rate

OBJECTIVETo evaluate the treatment results of T4 squamous cell carcinoma of the pyriform sinus.

METHODSSixty patients with T4 cancer of the pyriform sinus were included in this retrospective analysis. Fifteen patients were treated with radiotherapy alone (Ra group) with 67.9 Gy. Seven patients were treated with surgery alone (S group) with no laryngeal function sparing surgery. Sixteen patients were treated with preoperative radiotherapy with 49.8 Gy followed by surgery including three cases with laryngeal function sparing surgery (R + S group). Twenty-two patients were treated with surgery followed by postoperative radiotherapy with 58.5 Gy (S + R group), and there was no laryngeal function sparing surgery in this group. The survival rate was calculated using Kaplan-Meier method.

RESULTSThe overall 5-year survival rate for all patients was 32.4%, 8.7% for R group, 33.3% for S group, 29.2% for R+S group, 47.7% for S+R group, 41.7% for combined therapy group (R + S group and S+R group) and 13.6% for single therapy group (S group and R group). There was a statistically significant difference between the two groups (P = 0.02). The overall 5-year survival rates for R + S group and S + R group were 29.2% and 47.7%, respectively, with no significant difference (P = 0.228). Surgery complications for R + S group was 50.0% and 31.8% for S + R group, with no significant difference (P = 0.258).

CONCLUSIONSCombined therapy is the standard treatment modality for T4 squamous cell carcinoma of the pyriform sinus. Surgery with postoperative radiotherapy seems to be more advantageous.

Carcinoma, Squamous Cell ; radiotherapy ; surgery ; Combined Modality Therapy ; Humans ; Hypopharyngeal Neoplasms ; radiotherapy ; surgery ; Pyriform Sinus ; Retrospective Studies ; Survival Rate

Most patients with esophageal cancer have advanced disease at presentation. The efficacy of surgical resection alone is often unsatisfactory in patients with stage III or more advanced cancer according to the seventh edition of UICC staging system for esophageal cancer. The systematic multidisciplinary treatment is important. Mounting evidence indicates that preoperative concurrent chemoradiotherapy is the most effective induction therapy to down-stage tumor and increase radical resection rate. For the esophageal squamous cell carcinoma patients with multi-stations and multi-fields lymph node metastasis, preoperative induction chemotherapy would be a viable option. For locally advanced cancers which have been surgically resected, postoperative adjuvant radiotherapy maybe helpful to improve local control for the insufficient surgical dissection. The role of adjuvant chemotherapy also needs further studies. Thoracic esophageal squamous cell carcinoma and lower esophageal adenocarcinoma which is common in western countries are different. We need more prospective clinical studies to establish our treatment modalities for esophageal cancer.
Carcinoma, Squamous Cell ; drug therapy ; radiotherapy ; surgery ; Chemotherapy, Adjuvant ; Combined Modality Therapy ; Esophageal Neoplasms ; drug therapy ; radiotherapy ; surgery ; Humans ; Prospective Studies ; Radiotherapy, Adjuvant

To get a better understanding of the location, pathophysiology, etiology and prognosis of multiple malignant tumors (MPMT), we evaluated the medical records of 22 patients with MPMT. Our results suggested that radiotherapy and chemotherapy might play an important role in the pathogenesis of MPMT and follow-up is important in detecting a secondary primary malignant tumor (PMT) at an early stage. Surgical removal of tumors is the first-choice therapy for MPMT.
Adenocarcinoma ; drug therapy ; radiotherapy ; surgery ; Adult ; Aged ; Breast Neoplasms ; drug therapy ; radiotherapy ; surgery ; Carcinoma, Squamous Cell ; drug therapy ; radiotherapy ; surgery ; Colonic Neoplasms ; drug therapy ; radiotherapy ; surgery ; Combined Modality Therapy ; Female ; Humans ; Lung Neoplasms ; drug therapy ; radiotherapy ; surgery ; Male ; Middle Aged ; Neoplasms, Second Primary ; drug therapy ; radiotherapy ; surgery ; Prognosis ; Stomach Neoplasms ; drug therapy ; radiotherapy ; surgery

OBJECTIVE: To evaluate the treatment of advanced tonsillar carcinoma by radiotherapy plus salvage surgery (R+S) or surgery coupling with postoperative radiotherapy (S+R). METHOD: Clinical data of 48 patients with advanced tonsillar carcinoma who were treated in The 2nd Affiliated Hospital of Sun Yat-sen University from June 1996 to June 2004 was retrospectively analyzed. The patients were divided into R+S group (group A, 21 cases) and S+R group (group B, 27 cases). Treatment outcomes were compared between these two groups. The QOL (quality of life) scale of Washington University (UW-QOL) was used to investigate the patient's quality of life. RESULT: The 5-year survival rates were 42.9% in group A and 45.8% in group B, there was no significant statistical difference between the two groups (P < 0.05). Both the two treatment modalities could reduce the QOL in some degree. The average QOL score of 46 patients was 661.00 +/- 98.52 , group A was 696.09 + 90.70, while group B was 631.52 +/- 96.74, there was a significant statistical difference between the two groups (P < 0.05). CONCLUSION The two treatment modalities reached similar survivals. However, compared with the S+R, some patients who accepted treatment of R+S could avoid composite resection, reduce functional lesion and improve the QOL.
Adult ; Aged ; Carcinoma, Squamous Cell ; radiotherapy ; surgery ; therapy ; Female ; Humans ; Male ; Middle Aged ; Quality of Life ; Retrospective Studies ; Survival Rate ; Tonsillar Neoplasms ; radiotherapy ; surgery ; therapy ; Treatment Outcome

OBJECTIVETo evaluate perioperative radiotherapy and laryngeal preservation clinical result of hypopharyngeal pyriform sinus squamous cell carcinoma.

METHODSA retrospective review was undertaken of 134 pyriform sinus squamous cell carcinoma cases who were treated at this institute in Department of Head and Neck Surgery from September 1985 to July 2001. One hundred patients received preoperative radiotherapy and surgery (R + S). Thirty-four patients received surgery and postoperative radiotherapy (S + R). The median follow-up interval was 38.1 months.

RESULTS(R + S) and (S + R) group 3-year and 5-year survival according to Kaplan-Meier were 54.8%, 50.1%; 51.1%, 45.9% respectively, and had no significant differences (all P > .05). The laryngeal function preservation of T1, T2, T3, T4 in (R +S) and (S + R) were 4/5, 3/3; 66.7% (32/48), 6/6; 32.4% (12/37), 0 (0/16); 0 (0/10), 0/9 respectively. T3 stage in (R + S) was good and significant different than in (S + R) (P < 0.05) and laryngeal preservation didn't increase hazard of survival and local recurrence. The two group Pathology( + ,P + ) in specimen margin were 7.0% (7/100); 20.6% (7/34) and had significant difference (P <0. 05). P + in specimen margin and clinical N stage are obvious interrelated in prognosis(P < 0. 05).

CONCLUSIONSCombined therapy (R + S) and (S + R) are equal in treat result. T3 (only paraglottic space is invaded) stage of (R + S) could increase preserved laryngeal ratio if condition is permitted and didn't add hazard. P + in specimen margin could be receded in (R + S) and profit to prognosis and function. Clinical N stage is obvious hazard and is an emphasis in combined therapy.

Adult ; Aged ; Carcinoma, Squamous Cell ; radiotherapy ; surgery ; Combined Modality Therapy ; Female ; Humans ; Hypopharyngeal Neoplasms ; radiotherapy ; surgery ; Larynx ; physiopathology ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Retrospective Studies

OBJECTIVETo explore a better approach to resect the advanced oropharyngeal carcinoma.

METHODSFrom 1995 to 2005, 17 patients underwent mandibular swing procedure for excision of advanced oropharyngeal carcinoma including: 13 tonsillar cancers, 2 soft palate carcinomas and 2 lingual root cancers. Surgical procedure was selected according to the lesion. All tumors were resected through the mandibular swing approach or its combined approaches. Immediate reconstruction of the surgical defect was done using tongue flap, pectoralis major myocutaneous flap, sternohyoid myofascial flap, temporalis myofascial flap and forehead flap, respectively. After surgical resection of the tumors, all patients received postoperative radiotherapy.

RESULTSAll patients' advanced oropharyngeal carcinoma were successfully resected as planned through the mandibular swing procedure or its combined procedures without severe complications. Functions of deglutition, respiration and speech were well restored. The 3- and 5-year survival rate was 54. 5% and 40%, respectively.

CONCLUSIONThe mandibular swing procedure and its combined approach is safe and effective in the surgical resection of the advanced oropharyngeal carcinoma, which can provide a good exposure for the oropharynx, supraglottic region, hypopharynx, the parapharyngeal space and the base of the skull.

Adult ; Aged ; Carcinoma, Squamous Cell ; pathology ; radiotherapy ; surgery ; Combined Modality Therapy ; Female ; Humans ; Male ; Mandible ; radiation effects ; surgery ; Middle Aged ; Neoplasm Staging ; Oropharyngeal Neoplasms ; pathology ; radiotherapy ; surgery ; Postoperative Period ; Radiotherapy, Adjuvant ; Survival Analysis ; Tonsillar Neoplasms ; pathology ; radiotherapy ; surgery

OBJECTIVETo evaluate the surgical therapeutic strategy for non-small cell lung cancer (NSCLC) with (N2) mediastinal lymph node metastasis.

METHODSThe clinical data of 325 patients with N2 NSCLC treated surgically between 1961 and 1995 were analysed.

RESULTSThe over-all 5-year survival rate was 19.6%. Survival was higher in patients with radical resection than with palliative resection, with squamous-cell carcinoma than with adenocarcinoma, with sleeve lobectomy and pneumonectomy than with regular lobectomy, with 1 to 3 mediastinal metastatic lymph nodes than those over 4, and with adjuvant therapy (chiefly postoperative radiotherapy) than without. All these differences were statistically significant (P < 0.05). There was no 5-year survivor in patients with T3 or T4 tumor, nor in those with distant metastasis.

CONCLUSIONIt is suggested that surgery is the best choice for N2 NSCLC patients with T1 or T2 tumor, with non-adenocarcinoma, and with metastatic mediastinal lymph nodes less than 4 in number. Surgery is probably not a good choice in those with T3 tumor varieties. At operation, radical resection of the tumor and systematic removal of all hilar and mediastinal lymph nodes are essential for disease staging and survival improvement. Adjuvant therapy may improve long-term survival and is especially indicated in patients with residual tumor and/or metastatic mediastinal lymph nodes over 3 in number.

Adenocarcinoma ; drug therapy ; radiotherapy ; secondary ; surgery ; Adult ; Aged ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; radiotherapy ; secondary ; surgery ; Carcinoma, Squamous Cell ; drug therapy ; radiotherapy ; secondary ; surgery ; Chemotherapy, Adjuvant ; Female ; Follow-Up Studies ; Humans ; Lung Neoplasms ; drug therapy ; pathology ; radiotherapy ; surgery ; Lymph Node Excision ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Male ; Mediastinum ; Middle Aged ; Neoplasm Staging ; Pneumonectomy ; methods ; Radiotherapy, Adjuvant ; Survival Rate

OBJECTIVETo investigate the clinical features, treatment outcomes and possible prognostic factors in elderly patients with cervical cancer.

METHODSClinical data of 215 elderly women (> or = 65-years-old) with cervical cancer were retrospectively analyzed. Most patients (89.3%) had advanced stage ( II b-IV) disease. Eight of the 215 patients (3.7%) underwent surgical treatment, and six of those received postoperative radiotherapy. 133 patients received radiotherapy alone, and 74 patients underwent concurrent chemotherapy and radiotherapy.

RESULTSThe median follow-up time was 48 months (range: 12-102 months). The overall 5-year survival rate was 63.7%. The 5-year survival rate for stage I, II, III, IV were 83.2%, 76.4%, 39.0% and 0, respectively. There was no significant difference in 5-year survival rate between patients treated with concurrent chemotherapy combined with radiotherapy and radiotherapy alone. In multivariate analysis, lymph node metastasis, advanced stage, non-squamous histologies and poor differentiation were all negative prognostic factors for the overall survival.

CONCLUSIONThe treatment strategy for elderly cervical cancer patients should be individually planned according to the disease stage and performance status of the patients. Usually, one radical therapy modality can be chosen, and combined modality therapy is not suggested.

Adenocarcinoma ; drug therapy ; pathology ; radiotherapy ; surgery ; Adenocarcinoma, Clear Cell ; drug therapy ; pathology ; radiotherapy ; surgery ; Aged ; Antineoplastic Agents ; therapeutic use ; Carcinoma, Squamous Cell ; drug therapy ; pathology ; radiotherapy ; surgery ; Cisplatin ; therapeutic use ; Combined Modality Therapy ; Female ; Follow-Up Studies ; Humans ; Lymphatic Metastasis ; Neoplasm Staging ; Retrospective Studies ; Survival Rate ; Uterine Cervical Neoplasms ; drug therapy ; pathology ; radiotherapy ; surgery ; Young Adult