Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, South Korea.
Am J Otolaryngol. 2010 Jul-Aug;31(4):246-51. doi: 10.1016/j.amjoto.2009.02.007. Epub 2009 Jun 10.
The purpose of this study was to evaluate the appropriateness of the conservative surgery as the initial treatment of supraglottic cancer by the comparative study of supraglottic partial laryngectomy with radiation therapy.
We analyzed 48 patients diagnosed as having supraglottic cancer who underwent supraglottic partial laryngectomy and 20 patients treated with radiation therapy as initial treatment from 1991 to 2005. Oncologic safety was evaluated by comparison of survival rates. Swallowing test was performed with videoesophagofluoroscopy under the category of the pharyngeal phase and the presence or absence of aspiration. Phonologic analysis was performed with acoustic waveform analysis and stroboscopy.
Positive resection margin was observed in 12 of the patients who received supraglottic partial laryngectomy (SPL), and its relationship with the primary subsite was evaluated. For the patients in stages I and II, the overall survival rate in each of the SPL group and the radiotherapy (RTx) group was 87% and 80%, respectively. For the patients in stages III and IV, the overall survival rate was 87% and 80%, respectively. On evaluation of swallowing and phonation function, no significant difference was noted between the SPL group and the RTx group.
This study suggests that for patients with supraglottic cancer, SPL provides acceptable survival, swallowing, and phonologic results in comparison with radiation therapy.
本研究旨在通过比较喉声门上部分切除术与放疗治疗喉声门上癌，评估保守性手术作为声门上型癌初始治疗的适宜性。
我们分析了 1991 年至 2005 年间，48 例接受喉声门上部分切除术和 20 例接受放疗作为初始治疗的声门上型癌患者的临床资料。通过比较生存率来评估肿瘤学安全性。通过视频食管荧光透视检查对咽期和有无吸入进行吞咽测试。通过声学波形分析和声门镜检查进行语音分析。
接受喉声门上部分切除术的患者中有 12 例切缘阳性，并评估了其与原发亚部位的关系。对于 I 期和 II 期患者，喉声门上部分切除术组和放疗组的总生存率分别为 87%和 80%。对于 III 期和 IV 期患者，总生存率分别为 87%和 80%。在评估吞咽和发音功能方面，喉声门上部分切除术组和放疗组之间无显著差异。
本研究表明，对于声门上型癌患者，与放疗相比，SPL 可提供可接受的生存、吞咽和语音结果。
