Patil Vijay Maruti, Noronha Vanita, Joshi Amit, Muddu Vamshi, Poladia Bhavesh, Chauhan Bharat, Prabhash Kumar, Chaukar Devendra Arvind, Chatturvedi Pankaj, Pantvaidya Gouri, Juvekar Shashikant, D'cruz Anil
Department of Medical Oncology, Tata Memorial Hospital, Mumbai 400012, India.
Chemother Res Pract. 2012;2012:549170. doi: 10.1155/2012/549170. Epub 2012 Aug 12.
Background. The standard initial management of patients with locally advanced pharyngolaryngeal presenting with stridor is tracheostomy. Tracheostomy has been shown to negatively impact cancer-related outcomes. Methods. Retrospective analysis of prospectively collected data of 9 patients, who underwent induction chemotherapy with the aim of prevention of tracheostomy. Presenting features, time to resolution of stridor, and further management are reported. Results. Eight out of 9 patient received chemotherapy within 12 hours of presentation with stridor. There were 4 patients each with primary hypopharynx and larynx. The stage was IVA in 6 patients and IVB in 2 patients. In all patients receiving immediate chemotherapy, clinical stridor resolved within 48 hours. The radiological response rate was 62.5%. The median reduction in size of tumor was 37%. Conclusion. Immediate neoadjuvant chemotherapy is a feasible and safe option for patients presenting with early stridor and helps in resolution of stridor and avoiding tracheostomy.
背景。对于出现喘鸣的局部晚期咽喉部患者，标准的初始治疗方法是气管切开术。气管切开术已被证明会对癌症相关结局产生负面影响。方法。对9例接受诱导化疗以预防气管切开术的患者的前瞻性收集数据进行回顾性分析。报告了患者的临床表现、喘鸣缓解时间及后续治疗情况。结果。9例患者中有8例在出现喘鸣后12小时内接受了化疗。原发性下咽和喉部患者各有4例。6例患者为IVA期，2例患者为IVB期。所有接受即刻化疗的患者，临床喘鸣在48小时内缓解。放射学缓解率为62.5%。肿瘤大小的中位缩小率为37%。结论。对于早期出现喘鸣的患者，即刻新辅助化疗是一种可行且安全的选择，有助于缓解喘鸣并避免气管切开术。
