Balm A J, Snow G B, Karim A B, Versluis R J, Njo K H, Tiwari R M
Ann Otol Rhinol Laryngol. 1986 Nov-Dec;95(6 Pt 1):572-5. doi: 10.1177/000348948609500606.
From 1978 through 1985, eight patients with stomal recurrence after total laryngectomy were treated with a combination of a cytotoxic regimen (vincristin sulfate, bleomycin, and methotrexate [VBM]) and radiotherapy. The essential feature of this combination is the synchronous administration of pulses of VBM and fractionated doses of external radiotherapy in order to achieve potentiation of radiotherapy. On average, four to five pulses of VBM were given. Severe mucositis is the main problem during treatment. Two patients needed nasogastric tube feeding, and treatment was carried out as an inpatient procedure. Five patients are alive with complete local remission at 7 years, 3 years, 2 1/2 years, 14 months, and 8 months after treatment. These results appear to be spectacular, even though the number of patients is small. Of the three patients who died, only one had recurrent disease around the tracheostoma. The two other patients were free of disease in the neck when they died 6 and 16 months after treatment of, respectively, lung metastases and a second primary tumor in the lung. Patients with stomal recurrence after total laryngectomy are now routinely treated with synchronous VBM and radiotherapy.
1978年至1985年期间，8例全喉切除术后出现造口复发的患者接受了细胞毒性方案（硫酸长春新碱、博来霉素和甲氨蝶呤[VBM]）与放疗联合治疗。该联合治疗的关键特征是同步给予VBM脉冲和分次剂量的外照射放疗，以实现放疗增敏。平均给予四至五个VBM脉冲。严重黏膜炎是治疗期间的主要问题。两名患者需要鼻饲，治疗作为住院程序进行。5例患者在治疗后7年、3年、2年半、14个月和8个月时存活且局部完全缓解。尽管患者数量较少，但这些结果看起来很显著。在3例死亡患者中，只有1例在气管造口周围出现复发疾病。另外两名患者在分别因肺转移和肺部第二原发肿瘤接受治疗后6个月和16个月死亡时，颈部无疾病。全喉切除术后出现造口复发的患者现在常规接受同步VBM和放疗治疗。
