Clinical Review of Laryngeal Cancer: a Series of 626 Cases over the Past 33 Years
Clinical Review of Laryngeal Cancer: a Series of 626 Cases over the Past 33 Years
复制标题
喉癌临床回顾：33年626例
DOI：
10.5631/jibirin.99.299
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发表时间：
2006
期刊：
影响因子：
--
通讯作者：
Y. Seino
中科院分区：
文献类型：
--
作者：
M. Nakayama;M. Okamoto;M. Takeda;S. Miyamoto;Y. Seino
自1971年我们大学医院开业以来，喉癌的治疗方式发生了巨大的变化。在20世纪70年代，只有两种治疗选择：放射治疗和手术。20世纪80年代采用了化疗和激光手术，1997年，北里大学医院引入了器官保留手术、环状软骨上喉切除术、环舌骨会厌固定术和环舌骨固定术（SCL-CHEP和CHP）。本文回顾了33年来626例患者的临床资料。特别关注的是不同治疗时期（早期1971-1982年，中期1983-1993年，近期1994-2004年）的生存率和喉保留率。所有喉癌患者的5年粗生存率和病因特异性生存率分别为76%和85%。456例声门癌患者的5年病因特异性生存率分别为91%（早期）、91%（中期）和89%（近期）。生存率已经处于较高水平，不同时代之间没有显著差异。化疗的引入并没有显着提高生存率。早期、中期、近期喉功能保留率分别为68%、81%、83%。中期后引入的放化疗在喉保护中发挥了重要作用。器官保存手术，SCL-CHEP和SCL-CHP，在最近阶段治疗放射失败病例或晚期疾病的选定病例中发挥了重要作用。2002年修订了喉癌的UICC分期。应根据临床表现和CT影像对T3分期进行分类，以选择合适的治疗方法。
Treatment modalities of laryngeal cancer have enormously evolved since 1971, the year our university hospital opened. In the 1970's, there were only two treatment options: radiation therapy and surgery. Chemotherapy and laser surgery were employed in the 1980's and organ preservation surgery, supracricoid laryngectomy with cricohyoidoepiglottopexy and cricohyoidopexy (SCL-CHEP and CHP), were introduced in 1997 at Kitasato University Hospital. This paper reviewed the clinical data of 626 patients over the past 33 years. Special interest was focused on the survival rates and ratio of laryngeal preservation over different treatment eras (early stage 1971-1982, mid stage 1983-1993, recent stage 1994-2004). Five-year crude and cause-specific survival rates for all laryngeal cancer patients were 76% and 85 % respectively. Five-year cause-specific survival rates for 456 patients with glottic cancers were 91% (early stage), 91% (mid stage), and 89% (recent stage). Survival rate was already at the upper level and there was no marked difference among the different eras. Introduction of chemotherapy did not significantly contribute to improvement of the survival rate. The ratios of laryngeal preservation were 68%, 81%, 83% for early, mid, and recent stages, respectively. Chemoradiotherapy, introduced after the mid stage, has played a major role in laryngeal preservation. Organ preservation surgery, SCL-CHEP and SCL-CHP, played a major role in the recent stage for treating cases of radiation failure or selected cases of advanced diseases. UICC staging for laryngeal cancer was revised in 2002. Special attention must be paid to classifying the T3 stage based on the clinical features and CT images in order to choose the proper treatment modalities.