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[二氧化碳激光在喉癌中的部分内镜切除术。II. 结果]

[Partial endoscopic resection with the CO2 laser in laryngeal carcinomas. II. Results].

作者信息

Rudert H, Werner J A

机构信息

Klinik für Hals-, Nasen-, Ohrenheilkunde, Kopf- und Halschirurgie, Christian-Albrechts-Universität zu Kiel.

出版信息

Laryngorhinootologie. 1995 May;74(5):294-9. doi: 10.1055/s-2007-997743.

Abstract

This study presents the results of CO2 laser surgery in the curative treatment of 114 carcinomas of the vocal cord (Tis:8, T1a:88, T1b:10, T2:8) and 30 supraglottic carcinomas (T1:4, T2:11, T3:8, T4:7). In 21 patients with supraglottic carcinomas, additional radiotherapy was applied. Eleven patients underwent neck dissection. For the group of vocal cord carcinomas, 104 of 114 patients were free of recurrences after laser surgery. The ten recurrences were treated by irradiation (n = 3), repeated laser surgery (n = 3), and salvage laryngectomy (n = 3). One patient refused further treatment and died tumor related. 113 of 114 patients with glottic are without evidence of disease. For the group of patients with supraglottic carcinomas, six patients died without evidence of local disease. Two patients died of secondary malignancy without evidence of local recurrence. Four patients died of their tumor. Today, eighteen patients are without evidence of local or metastatic disease. In fourteen of these patients, the follow-up is longer than two years. Our data indicate that the oncological outcome after laser surgery is comparable to conventional open partial resection, whereas the functional outcome especially in supraglottic carcinomas is superior following laser surgery. In comparison to radiotherapy, the oncological outcome after laser surgery is better and functional results are only slightly inferior. Laser surgery should therefore take its place as an established treatment of supraglottic and glottic carcinomas.

摘要

本研究展示了二氧化碳激光手术治疗114例声带癌(Tis:8例,T1a:88例,T1b:10例,T2:8例)和30例声门上癌(T1:4例,T2:11例,T3:8例,T4:7例)的疗效。21例声门上癌患者接受了辅助放疗。11例患者接受了颈部清扫术。对于声带癌组,114例患者中有104例在激光手术后无复发。10例复发患者分别接受了放疗(3例)、再次激光手术(3例)和挽救性喉切除术(3例)。1例患者拒绝进一步治疗,死于肿瘤相关原因。114例声门癌患者中有113例无疾病证据。对于声门上癌患者组,6例患者无局部疾病证据死亡。2例患者死于继发性恶性肿瘤,无局部复发证据。4例患者死于肿瘤。目前,18例患者无局部或转移疾病证据。其中14例患者的随访时间超过两年。我们的数据表明,激光手术后的肿瘤学结果与传统开放性部分切除术相当,而激光手术后的功能结果,尤其是声门上癌的功能结果更优。与放疗相比,激光手术后的肿瘤学结果更好,功能结果仅略逊一筹。因此,激光手术应成为声门上癌和声门癌的既定治疗方法。

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