van Loon Yda, Hendriksma Martine, Langeveld Ton P M, de Jong Martin A, Baatenburg de Jong Rob J, Sjögren Elisabeth V
1 Department of Otorhinolaryngology, Head & Neck Surgery, Leiden University Medical Center, Leiden, the Netherlands.
2 Department of Radiotherapy, Leiden University Medical Center, Leiden, the Netherlands.
Ann Otol Rhinol Laryngol. 2018 Mar;127(3):139-145. doi: 10.1177/0003489417749253. Epub 2017 Dec 31.
For early glottic carcinoma, the 2 main treatment modalities are radiotherapy (RT) and transoral CO laser microsurgery (TLM). The aim of this study was to investigate treatment preferences and considerations in patients with early glottic carcinoma (T1-T2) who were given a choice between TLM and RT.
Patients with early glottic cancer (suspected or confirmed extended T1 or limited T2) were counseled by an ENT-surgeon. A subset of 32 patients was also counseled by a radiotherapist. Treatment choice and considerations were recorded and analyzed.
Of 175 patients, 168 patients (96%) chose TLM, and 7 patients (4%) chose RT. The most common reason for choosing TLM was shorter treatment and more treatment options in case of recurrence. Subanalysis showed that additional counseling by the radiotherapist did not seem to affect our patients' preferences for TLM in this group.
The majority of patients in our study prefer TLM to RT when given a choice. Reasons given indicate that optimizing future treatment options and practical considerations seemed more important to our patients than primary functional outcome. Further research is needed to study patient-related and physician-related factors to gain more insight into this complicated process of shared decision making.
对于早期声门癌，两种主要的治疗方式是放射治疗（RT）和经口CO2激光显微手术（TLM）。本研究的目的是调查在早期声门癌（T1-T2）患者中，在TLM和RT之间做出选择时的治疗偏好和考虑因素。
早期声门癌患者（疑似或确诊为扩展型T1或局限型T2）由耳鼻喉科医生提供咨询。32名患者的子集也由放疗科医生提供咨询。记录并分析治疗选择和考虑因素。
在175名患者中，168名患者（96%）选择了TLM，7名患者（4%）选择了RT。选择TLM最常见的原因是治疗时间较短以及复发时治疗选择更多。亚分析表明，放疗科医生的额外咨询似乎并未影响该组患者对TLM的偏好。
在本研究中，大多数患者在有选择的情况下更喜欢TLM而非RT。给出的原因表明，对我们的患者来说，优化未来的治疗选择和实际考虑因素似乎比主要功能结果更重要。需要进一步研究患者相关和医生相关因素，以更深入地了解这一复杂的共同决策过程。
