Department of Head and Neck Surgery, Instituto Nacional de Cancerología (Mexico), Av, San Fernando #22, Tlalpan, Mexico, D,F,, 14080, Mexico.
World J Surg Oncol. 2009 Dec 19;7:101. doi: 10.1186/1477-7819-7-101.
To assess functional results, complications, and success of larynx preservation in patients with recurrent squamous cell carcinoma after radiotherapy.
From a database of 40 patients who underwent supracricoid partial laryngectomy (SCPL) with cricohyoidoepiglottopexy (CHEP) from June 2001 to April 2006, eight patients were treated previously with radiotherapy due to squamous cell carcinoma of the glottic region and were treated for recurrence at the site of the primary cancer.
SCPL with CHEP was performed in six men and two women with a mean age of 67 years due to recurrence and/or persistence at a mean time of 30 months postradiotherapy (in case #8 after concomitant chemoradiotherapy). Bilateral neck dissection at levels II-V was performed in six patients. Only case #8 presented metastasis in one node. In case #5, Delphian node was positive. It was possible to preserve both arytenoids in five cases. Definitive surgical margins were negative. Complications were encountered in seven patients. Follow-up was on average 44 months (range: 20-67 months). Organ preservation in this series was 75%, and local control was 87%. Overall 5-year survival was 50%.
In selected patient with persistence and/or recurrence after radiotherapy due to cancer of the larynx, SCPL with CHEP seems to be feasible with acceptable local control and toxicity. Complications may occur as in previously non-irradiated patients. These complications must be treated conservatively to avoid altering laryngeal function.
评估功能结果、并发症和放射治疗后复发性鳞状细胞癌患者保留喉的成功率。
从 2001 年 6 月至 2006 年 4 月接受过声门上型喉部分切除术（SCPL）联合环舌会厌固定术（CHEP）的 40 例患者的数据库中，选择 8 例因声门区鳞状细胞癌接受过放射治疗且因原发性癌症部位复发而接受治疗的患者。
6 例男性和 2 例女性患者因复发和/或放疗后 30 个月（#8 例患者同时接受放化疗后）平均时间出现持续性疾病而行 SCPL 联合 CHEP。6 例患者行双侧 II-V 颈清扫术。仅 #8 例患者有 1 个淋巴结转移。#5 例患者有 Delphian 淋巴结阳性。5 例患者成功保留双侧杓状软骨。切缘均为阴性。7 例患者发生并发症。平均随访时间为 44 个月（范围：20-67 个月）。该系列中器官保留率为 75%，局部控制率为 87%。总 5 年生存率为 50%。
对于因喉癌接受放疗后出现持续性或复发性疾病的选择患者，SCPL 联合 CHEP 似乎可行，局部控制和毒性可接受。与之前未接受过放疗的患者一样，可能会发生并发症。这些并发症必须保守治疗，以避免改变喉功能。
