Barthel S W, Esclamado R M
Department of Otolaryngology and Communicative Disorders, Cleveland Clinic Foundation, OH 44195, USA.
Otolaryngol Head Neck Surg. 2001 Jan;124(1):35-9. doi: 10.1067/mhn.2001.112574.
OBJECTIVES/HYPOTHESIS: Early glottic squamous cell carcinoma can be effectively treated with either radiation or surgical intervention. We evaluated our experience treating early glottic cancer with primary radiation therapy and our vertical hemilaryngectomy (VHL) salvage experience.
STUDY DESIGN/METHODS: Retrospectively, patient records between January 1986 and December 1994 were reviewed and 45 patients with early glottic squamous cell carcinoma who received full-course radiation therapy at the Cleveland Clinic Foundation were identified.
Local control after radiation therapy was 80% overall, 87.5% for T1 lesions, and 75% for T2 lesions. Four patients underwent VHL for salvage after local recurrence; 1 was successfully salvaged with VHL. Five patients underwent total laryngectomy salvage after radiation therapy; all were successful. Only 1 of the 6 patients who were originally candidates for VHL before radiation therapy was successfully salvaged with the larynx preserved.
Our local control rates using primary radiation therapy are consistent with prior published series, but voice sparing salvage is poor.
目的/假设：早期声门鳞状细胞癌可通过放疗或手术干预有效治疗。我们评估了我们采用原发性放射治疗早期声门癌的经验以及垂直半喉切除术（VHL）挽救治疗的经验。
研究设计/方法：回顾性分析1986年1月至1994年12月期间的患者记录，确定了45例在克利夫兰诊所基金会接受全程放射治疗的早期声门鳞状细胞癌患者。
放疗后的总体局部控制率为80%，T1病变为87.5%，T2病变为75%。4例患者在局部复发后接受VHL挽救治疗；1例通过VHL成功挽救。5例患者在放疗后接受全喉切除术挽救治疗；均成功。最初在放疗前符合VHL条件的6例患者中，只有1例成功保留喉进行挽救。
我们采用原发性放射治疗的局部控制率与先前发表的系列研究一致，但保留嗓音的挽救治疗效果不佳。
