Piotrowski Slawomir Marian
Oddział Otolaryngologii Szpitala Miejskiego im. J. Brudziftskiego w Gdyni.
Otolaryngol Pol. 2007;61(3):243-53. doi: 10.1016/S0030-6657(07)70421-3.
Author discusses problems and treatment principles of patients with massive postradiation injury, who had laryngectomy procedure as a result of insufficience of the farmacological treatment.
There were 12 patients who were performed laryngectomy as a treatment of massive postradiation injury of the larynx in the period 1975-2005. We suspected presence of persistent neoplasm with postradiation changes. Seven laryngectomies were performed after confirmation of the neoplasm in 1-3 biopsies. Three patients were treated operatively without this confirmation in spite of two biopsies which were negatively, and two patients were treated in this way without biopsies.
Two patients had tomour free postlaryngectomy specimens in the histopathological examinations, and among 10 others the reccurence of the tumour after radiotherapy was present during the post-laryngectomy histopathological examinations. In 7 cases this reccurence was proved with massive postradiation injury in endoscopic biopsies before laryngectomy.
Author presents his own problems and presents methods of treatment of the patients with massive postradiation injury of the larynx described in literature.
作者探讨了因药物治疗不足而接受喉切除术的大面积放疗后损伤患者的问题及治疗原则。
1975年至2005年期间,有12例患者因喉部大面积放疗后损伤接受了喉切除术。我们怀疑存在伴有放疗后改变的持续性肿瘤。7例在1 - 3次活检确诊肿瘤后进行了喉切除术。尽管两次活检结果为阴性,但仍有3例患者在未确诊的情况下接受了手术治疗,另有2例患者未进行活检就接受了这种治疗。
组织病理学检查显示,2例患者喉切除术后标本无肿瘤,另外10例患者在喉切除术后组织病理学检查中出现放疗后肿瘤复发。7例患者在喉切除术前的内镜活检中被证实存在伴有大面积放疗后损伤的肿瘤复发。
作者提出了自己遇到的问题,并介绍了文献中描述的喉部大面积放疗后损伤患者的治疗方法。