Wang M B, Lavey R S, Calcaterra T C
Department of Surgery, University of California School of Medicine, Los Angeles 90024.
Laryngoscope. 1990 Nov;100(11):1146-51. doi: 10.1288/00005537-199011000-00002.
In recent years, we have seen increasing use of partial laryngectomies for larger lesions that were previously treated by total laryngectomy. The resultant closer margins have made postoperative radiation therapy an important adjuvant treatment to conservation laryngeal surgery. We review the University of California, Los Angeles, experience with combination partial laryngectomy and postoperative radiation therapy between 1973 and 1987 for treatment of carcinoma of the larynx. Twenty-four such patients who underwent partial laryngectomies and postoperative radiation therapy are examined. Techniques of treatment, complications, and the functional ability of the remaining larynx are discussed. The locoregional control rate at 5 years was 80%. Risk factors associated with an increased risk of recurrence were positive margins, vascular invasion, and extranodal spread. There were no major problems with postoperative wound healing or airway management during the radiation treatment. Vocal and swallowing function were well preserved in most cases. We conclude that combination partial laryngectomy and radiation therapy permits preservation of laryngeal function without serious complications, and therefore is an effective treatment for selected patients with carcinoma of the larynx.
近年来，我们发现对于以前需行全喉切除术治疗的较大病变，越来越多地采用了部分喉切除术。由此产生的切缘更近，使得术后放射治疗成为保留喉手术的重要辅助治疗。我们回顾了加利福尼亚大学洛杉矶分校1973年至1987年间采用联合部分喉切除术及术后放射治疗来治疗喉癌的经验。对24例接受部分喉切除术及术后放射治疗的患者进行了检查。讨论了治疗技术、并发症以及剩余喉部的功能状况。5年局部区域控制率为80%。与复发风险增加相关的危险因素为切缘阳性、血管侵犯及结外扩散。放射治疗期间术后伤口愈合或气道管理方面未出现重大问题。大多数病例中，发音和吞咽功能得到了良好保留。我们得出结论，联合部分喉切除术和放射治疗能够保留喉功能且无严重并发症，因此对于部分喉癌患者是一种有效的治疗方法。
