Vocal Fold Vibration After Photofrin-Mediated Photodynamic Therapy for Treatment of Early-Stage Laryngeal Malignancies
Vocal Fold Vibration After Photofrin-Mediated Photodynamic Therapy for Treatment of Early-Stage Laryngeal Malignancies
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DOI：
10.1016/j.jvoice.2013.07.010
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发表时间：
2013-11-01
期刊：
影响因子：
2.2
通讯作者：
Peterson, Ed
中科院分区：
文献类型：
--
作者：
Silbergleit, Alice K.;Somers, Melissa L.;Peterson, Ed
目标/假设。分析光敏素介导的光动力疗法 (PDT) 治疗 Tis 和 T1N0M0 喉鳞状细胞癌 (SqCCa) 肿瘤后的声带振动。据推测，声带振动的关键属性将在治疗 1-6 个月内恢复到基线。研究设计。回顾性方法。回顾性分析了 8 名接受光敏素介导的 PDT 治疗的喉部 Tis-T1N0M0 SqCCa 肿瘤患者的喉视频频闪镜数据。声带选定振动特征的基线和治疗后视频频闪镜图像由言语病理学家和专门研究声音障碍的经过专科培训的喉科医生进行随机和分析。结果。与基线相比，PDT 后大于或等于 20 周时，粘膜波 (P = 0.003) 和振动幅度 (P = 0.004) 出现显着改善。将术后 5 周内的结果与术后 10-19 周的结果进行比较，发现振动幅度 (P = 0.013) 和声带非振动部分 (P = 0.020) 显着改善。将术后 5 周内的结果与术后 20 周或更长时间的结果进行比较，发现振动幅度 (P = 0.001)、粘膜波 (P = 0.001) 和受影响皱襞的非振动部分 (P = 0.001) 显着改善。结论。 Photofrin 介导的 PDT 可以保留喉部的功能和结构，而不会产生全身毒性；然而，治疗后声带的关键振动特征可能需要 4-5 个月或更长时间才能恢复。
Objective/Hypothesis. To analyze vocal fold vibration after photofrin-mediated photodynamic therapy (PDT) for the treatment of Tis and T1N0M0 squamous cell carcinoma (SqCCa) tumors of the larynx. It was hypothesized that key attributes of vocal fold vibration would return to baseline within 1-6 months of treatment.Study Design. Retrospective.Methods. Laryngovideostroboscopic data were retrospectively analyzed for eight patients with Tis-T1N0M0 SqCCa tumors of the larynx treated with photofrin-mediated PDT. Baseline and posttreatment videostroboscopy images of select vibratory characteristics of the vocal folds were randomized and analyzed by a speech-language pathologist and fellowship-trained laryngologist specializing in voice disorders.Results. Significant improvement in mucosal wave (P = 0.003) and amplitude of vibration (P = 0.004) occurred at greater than or equal to 20 weeks post-PDT compared with baseline. Comparing results within 5 weeks postprocedure to 10-19-weeks postprocedure revealed significant improvement in amplitude of vibration (P = 0.013) and nonvibrating portion of the vocal fold (P = 0.020). Comparing results within 5-weeks postprocedure to 20 or more weeks postprocedure revealed significant improvement in amplitude of vibration (P = 0.001), mucosal wave (P = 0.001), and nonvibrating portion of the effected fold (P = 0.001).Conclusion. Photofrin-mediated PDT allows for preservation of function and structure of the larynx without systemic toxicity; however, it may take 4-5 months or more for key vibratory characteristics of the vocal folds to recover posttreatment.