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经口机器人手术治疗口咽癌的肿瘤学和功能结局

Oncological and functional outcomes of transoral robotic surgery for oropharyngeal cancer.

作者信息

Park Young Min, Kim Won Shik, Byeon Hyung Kwon, Lee Sei Young, Kim Se-Heon

机构信息

Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea.

出版信息

Br J Oral Maxillofac Surg. 2013 Jul;51(5):408-12. doi: 10.1016/j.bjoms.2012.08.015. Epub 2012 Oct 9.

Abstract

In this prospective study we analysed the oncological and functional results of transoral robotic surgery (TORS) to find out if it was suitable as a minimally invasive treatment for oropharyngeal cancer. Between April 2008 and September 2011, 39 patients with oropharyngeal cancer were treated by TORS. We assessed overall and disease-free survival by the Kaplan-Meier test, and we used videopharyngography and the functional outcome swallowing scale (FOSS) to evaluate swallowing. We used nasometry to estimate hypernasality, and acoustic waveform analysis to evaluate the voice. Thirty-seven patients (95%) had histologically clear margins of resection. Overall survival at 2 years was 96% and disease-free survival 92%. An oral diet was tolerable after a mean of 6 (range 1-18) days. No serious swallowing difficulties were seen on the videopharyngogram. Thirty-six of 38 patients could swallow well (97%) with FOSS scores ranging from 0 to 2 (1 patient had a poor score but was able to take an oral diet after postural training). Voices were maintained close to the normal range on the acoustic waveform analysis. The oncological and functional results of TORS were quite acceptable for the treatment of oropharyngeal cancer. TORS is a valid treatment for selected patients with oropharyngeal cancer.

摘要

在这项前瞻性研究中,我们分析了经口机器人手术(TORS)的肿瘤学和功能结果,以确定其是否适合作为口咽癌的微创治疗方法。2008年4月至2011年9月期间,39例口咽癌患者接受了TORS治疗。我们通过Kaplan-Meier检验评估总生存期和无病生存期,并使用视频咽造影术和功能结局吞咽量表(FOSS)来评估吞咽功能。我们使用鼻音测量法评估鼻音过重,并通过声学波形分析评估嗓音。37例患者(95%)的组织学切缘清晰。2年总生存率为96%,无病生存率为92%。平均6天(范围1-18天)后可耐受经口进食。视频咽造影未发现严重吞咽困难。38例患者中有36例(97%)吞咽良好,FOSS评分在0至2分之间(1例评分较差,但经体位训练后能够经口进食)。声学波形分析显示嗓音维持在接近正常范围。TORS治疗口咽癌的肿瘤学和功能结果相当可观。TORS是治疗部分口咽癌患者的有效方法。

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