经口激光显微手术作为特定T3期声门癌和声门上癌的主要治疗方法。
Transoral laser microsurgery as primary treatment for selected T3 glottic and supraglottic cancers.
作者信息
Peretti Giorgio, Piazza Cesare, Penco Sara, Santori Gregorio, Del Bon Francesca, Garofolo Sabrina, Paderno Alberto, Guastini Luca, Nicolai Piero
机构信息
Department of Otorhinolaryngology - Head and Neck Surgery, University of Genoa, Genoa, Italy.
Department of Otorhinolaryngology - Head and Neck Surgery, University of Brescia, Brescia, Italy.
出版信息
Head Neck. 2016 Jul;38(7):1107-12. doi: 10.1002/hed.24424. Epub 2016 Mar 11.
BACKGROUND
T3 laryngeal cancer encompasses heterogeneous lesions whose treatment is still debated. The purpose of this study was to evaluate transoral laser microsurgery (TLM) in management of selected T3 glottic and supraglottic cancers.
METHODS
Fifty-six patients with selected T3 glottic and supraglottic squamous cell carcinomas (SCCs) treated by TLM ± selective neck dissection ± adjuvant therapy were evaluated in terms of overall survival (OS), disease-free survival (DFS), and organ preservation rates.
RESULTS
For the entire cohort, 5-year OS and DFS were 63.3% and 72.4%, whereas they were 65.2% and 72.9% for glottic and 59.3% and 76.3% for supraglottic SCC, respectively. No patient required permanent tracheostomy and 1 patient was gastrostomy tube-dependent at last follow-up.
CONCLUSION
TLM ± selective neck dissection ± adjuvant (chemo)radiotherapy for selected T3 glottic and supraglottic SCC represents an effective alternative treatment to open partial laryngectomies and nonsurgical organ preservation protocols, particularly in elderly and frail patients. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1107-1112, 2016.
背景
T3期喉癌包含异质性病变，其治疗方法仍存在争议。本研究的目的是评估经口激光显微手术（TLM）在特定T3期声门型和声门上型癌症治疗中的应用。
方法
对56例接受TLM±选择性颈清扫术±辅助治疗的特定T3期声门型和声门上型鳞状细胞癌（SCC）患者的总生存率（OS）、无病生存率（DFS）和器官保留率进行了评估。
结果
对于整个队列，5年总生存率和无病生存率分别为63.3%和72.4%，声门型SCC分别为65.2%和72.9%，声门上型SCC分别为59.3%和76.3%。在最后一次随访时，没有患者需要永久性气管造口术，1例患者依赖胃造瘘管。
结论
对于特定的T3期声门型和声门上型SCC，TLM±选择性颈清扫术±辅助（化疗）放疗是开放性部分喉切除术和非手术器官保留方案的一种有效替代治疗方法，尤其适用于老年和体弱患者。©2016威利期刊公司。头颈外科38:1107 - 1112,2016年。
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