Treatment of laryngeal carcinoma with conservative surgery and postoperative radiation therapy.
Treatment of laryngeal carcinoma with conservative surgery and postoperative radiation therapy.
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喉癌的治疗采用保守手术和术后放射治疗。
DOI：
10.1001/archotol.1978.00790100030006
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发表时间：
1978
影响因子：
--
通讯作者：
R. Lindberg
中科院分区：
文献类型：
--
作者：
H. Goepfert;H. Goepfert;H. Zaren;R. Jesse;R. Lindberg
13 名患有喉上癌 (N = 10)、声带癌 (N = 2) 和梨状窦癌 (N = 1) 的患者接受保守手术，随后进行放射治疗。选择该方案是因为临床或组织学证明存在淋巴结转移，并且原发癌具有以下一种或多种不利于患者生存的因素：（1）肿瘤超出了安全、保守的喉部手术的范围； (2)浸润周围软组织，即会厌前间隙； (3)接近切除边缘的； (4)存在神经周围侵犯。除两名患者外，所有患者的喉功能均良好：一名患者在治疗一年后出现持续性误吸，一名患者在扩大声门上喉切除术后出现气道狭窄，该切除术包括双声带的前三分之一以及前连合处与邻近甲状软骨的声门下部分。一名患者在术后立即死亡，该病例无法评估。完成治疗的 12 名患者接受了中位 30 个月（1 1/2 至 3 1/2 年）的随访，所有患者均未出现疾病复发。
Thirteen patients with carcinoma of the supragiottic larynx (N = 10), vocal cord (N = 2), and pyriform sinus (N = 1) were treated with conservative surgery followed by radiation therapy. This plan was chosen because clinically or histologically proven lymph node metastases were present and because the primary cancer had one or more of the following factors that were adverse to patient survival: (1) the tumor extended beyond the limits of safe, conservative laryngeal surgery; (2) it infiltrated surrounding soft tissues, ie, preepiglottic space; (3) it was close to the resected margin; and (4) perineural invasion was present. Laryngeal function has been adequate in all but two patients: one has persistent aspiration one year after treatment, and one has a narrow airway after an extended supraglottic laryngectomy that included the anterior third of both cords and a portion of the subglottis at the anterior commissure with adjacent thyroid cartilage. One patient died in the immediate postoperative period, and this case cannot be evaluted. Twelve patients who completed treatment have been followed up for a median of 30 months (1 1/2 through 3 1/2 years), and all have remained free of recurrent disease.