经放射治疗的喉癌患者的经口激光微创手术。
Transoral laser microsurgery in previously irradiated patients with laryngeal cancer.
机构信息
Department of Otolaryngology, University of Miami-Leonard M. Miller School of Medicine, Miami, FL, USA.
Department of Otolaryngology, University of Miami-Leonard M. Miller School of Medicine, Miami, FL, USA.
出版信息
Am J Otolaryngol. 2014 May-Jun;35(3):279-85. doi: 10.1016/j.amjoto.2014.03.004. Epub 2014 Mar 12.
PURPOSE
Early laryngeal cancer is successfully managed with transoral laser microsurgery. Previously radiated patients may experience more post-operative complications. We investigate disease-free survival and secondarily prolonged pain and chondronecrosis.
MATERIALS AND METHODS
Retrospective review of 52 patients undergoing transoral laser microsurgery after previous radiation.
RESULTS
Mean disease-free survival was 36.7 months. Overall disease-free survival was 57.6% at 3-year and 48.4% at 5-year follow-up, with no significant difference between surgery within as opposed to after 60 months of radiation or within as opposed to after 12 months of radiation. Thirteen patients, all with surgery within 60 months of radiation, experienced prolonged pain. Twelve experienced chondronecrosis, all within 12 months of surgery.
CONCLUSION
Transoral laser microsurgery for early laryngeal cancer is an adequate therapeutic option in patients with history of radiation with comparable disease-free survival to other reports. Patients undergoing transoral laser microsurgery within 60 months of radiation treatment are more likely to experience prolonged pain.
目的
早期喉癌经经口激光微创手术治疗效果良好。既往接受过放射治疗的患者可能会出现更多术后并发症。我们研究了无病生存率，以及其次出现的疼痛延长和软骨坏死。
材料和方法
回顾性分析了 52 例既往接受过放射治疗后行经口激光微创手术的患者。
结果
无病生存率的平均值为 36.7 个月。3 年和 5 年的总体无病生存率分别为 57.6%和 48.4%，放射治疗后 60 个月内或 12 个月内手术与放射治疗后 60 个月以上或 12 个月以上手术之间的无病生存率无显著差异。13 例患者均在放射治疗后 60 个月内接受手术，经历了疼痛延长。12 例患者均在术后 12 个月内发生软骨坏死。
结论
对于有放射治疗史的早期喉癌患者，经口激光微创手术是一种适当的治疗选择，无病生存率与其他报道相当。在放射治疗后 60 个月内接受经口激光微创手术的患者更有可能出现疼痛延长。
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