Shushan S, Cinamon U, Levy D, Sokolov M, Roth Y
Department of Otolaryngology-Head & Neck Surgery and Tel Aviv University Sackler School of Medicine, The Edith Wolfson Medical Center, Holon, Israel.
Int J STD AIDS. 2009 Aug;20(8):582-4. doi: 10.1258/ijsa.2008.008345.
With improved survival, more AIDS patients, especially heavy smokers and alcohol abusers, may be confronted with laryngeal squamous cell carcinoma. Since curative treatment may require aggressive combined therapy, these patients, often suffering from immunosupression and poor general condition, present unique therapeutic challenges. The objective of the study was to describe treatment dilemmas. This case report presents a detailed description of an AIDS patient with carcinoma of the larynx. A patient with T3N0M0 laryngeal carcinoma and AIDS underwent tracheotomy and biopsy, followed by severe neck and pulmonary infection. After convalescence, radiotherapy was administered, with no evidence of a disease during a 3.5-year follow-up. During his remaining life, the patient developed severe psychoaffective disorder, his immune state deteriorated until he demised from sepsis. In conclusion, patients with HIV infection, especially having a history of tobacco or alcohol abuse, should be carefully examined for head and neck carcinoma that is likely to be more aggressive. Following surgery, AIDS patients may have worse wound healing and a greater tendency to contract infections. Radiotherapy and especially chemotherapy may cause life-threatening complications. Although early detection may increase survival, curative treatment should involve many disciplines and extra caution.
随着生存率的提高，越来越多的艾滋病患者，尤其是重度吸烟者和酗酒者，可能会面临喉鳞状细胞癌。由于根治性治疗可能需要积极的联合治疗，这些经常患有免疫抑制和全身状况较差的患者面临着独特的治疗挑战。本研究的目的是描述治疗困境。本病例报告详细描述了一名患有喉癌的艾滋病患者。一名患有T3N0M0喉癌和艾滋病的患者接受了气管切开术和活检，随后出现严重的颈部和肺部感染。康复后，进行了放射治疗，在3.5年的随访期间没有疾病迹象。在他剩余的生命中，患者出现了严重的精神情感障碍，免疫状态恶化，最终死于败血症。总之，艾滋病毒感染患者，尤其是有吸烟或酗酒史的患者，应仔细检查是否患有可能更具侵袭性的头颈癌。手术后，艾滋病患者的伤口愈合可能更差，感染的倾向更大。放射治疗尤其是化疗可能会导致危及生命的并发症。虽然早期发现可能会提高生存率，但根治性治疗应涉及多个学科并格外谨慎。
