放疗失败后的环状软骨上部分喉切除术：一项多机构研究系列
Supracricoid partial laryngectomies after radiation failure: a multi-institutional series.
作者信息
Pellini Raul, Pichi Barbara, Ruscito Paolo, Ceroni Alberto Rinaldi, Caliceti Umberto, Rizzotto Giuseppe, Pazzaia Antonio, Laudadio Pasquale, Piazza Cesare, Peretti Giorgio, Giannarelli Diana, Spriano Giuseppe
机构信息
Department of Otorhinolaryngology-Head and Neck Surgery, National Cancer Institute Regina Elena, Rome, Italy.
出版信息
Head Neck. 2008 Mar;30(3):372-9. doi: 10.1002/hed.20709.
BACKGROUND
Radiation therapy (RT) is one of the gold standard treatments for early laryngeal cancer, and total laryngectomy is still the most applied surgical procedure after failure. Selected recurrences can be managed by supracricoid partial laryngectomies (SCPLs).
METHODS
A multi-institutional retrospective analysis was carried out in 78 consecutive patients treated by SCPLs for the recurrence of glottic-supraglottic cancer after RT. Cricohyoidoepiglottopexy was performed in 62, and cricohyoidopexy (CHP) in 16 cases.
RESULTS
Disease-free survival at 3 and 5 years were 95.5%. Early and late postoperative complications occurred in 27% and 17.9% of cases. Decannulation and satisfactory swallowing were achieved in 97.4% of cases.
CONCLUSIONS
SCPLs represent effective surgical organ-preservation strategies in the treatment of selected recurrences after RT failure, resulting in a good local control as well as functional recovery with acceptable morbidity, despite a complication rate which is not negligible.
背景
放射治疗（RT）是早期喉癌的金标准治疗方法之一，全喉切除术仍是治疗失败后最常用的外科手术。部分复发患者可采用环状软骨上部分喉切除术（SCPL）治疗。
方法
对78例接受SCPL治疗的声门-声门上癌放疗后复发患者进行多机构回顾性分析。其中62例行环状软骨舌骨会厌固定术，16例行环状软骨舌骨固定术（CHP）。
结果
3年和5年无病生存率为95.5%。术后早期和晚期并发症发生率分别为27%和17.9%。97.4%的患者实现了拔管且吞咽功能良好。
结论
SCPL是治疗放疗失败后部分复发患者有效的保留器官手术策略，尽管并发症发生率不可忽视，但能实现良好的局部控制和功能恢复，且发病率可接受。
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