Tart R P, Mukherji S K, Lee W R, Mancuso A A
Department of Radiology, University of Florida, Gainesville 32610.
Radiology. 1994 Aug;192(2):567-70. doi: 10.1148/radiology.192.2.8029433.
To determine whether sclerosis of the laryngeal cartilages was a predictor of a poor outcome in patients with stage T3 glottic cancer treated with radiation therapy.
Thirty-three patients with stage T3 glottic cancer underwent computed tomography (CT) before radiation therapy. Twenty-two patients underwent posttreatment CT. The presence of cartilage sclerosis, cartilage erosion, marrow invasion, and cartilage necrosis was determined.
Nineteen of the 33 patients had cartilage sclerosis at CT. Seventeen patients had sclerosis of a single laryngeal cartilage (14 arytenoid, two cricoid, and one thyroid), and two had sclerosis of adjacent laryngeal cartilages (arytenoid and cricoid in both cases). Of the 17 patients with isolated laryngeal cartilage sclerosis, disease was controlled with radiation therapy alone in 15 and with salvage laryngectomy in two. Both patients with cricoid and arytenoid sclerosis died of their original cancer despite undergoing early salvage laryngectomy. Of the 14 patients without sclerosis, eight had no evidence of disease, two died of their disease, and four died of intercurrent disease.
T3 glottic cancer with isolated laryngeal cartilage sclerosis can be cured with radiation therapy.
确定喉软骨硬化是否是接受放射治疗的T3期声门癌患者预后不良的预测指标。
33例T3期声门癌患者在放疗前接受了计算机断层扫描（CT）检查。22例患者接受了治疗后CT检查。确定是否存在软骨硬化、软骨侵蚀、骨髓侵犯和软骨坏死。
33例患者中有19例在CT检查时存在软骨硬化。17例患者单个喉软骨硬化（14例杓状软骨、2例环状软骨和1例甲状软骨），2例相邻喉软骨硬化（均为杓状软骨和环状软骨）。在17例孤立性喉软骨硬化患者中，15例仅通过放射治疗控制了疾病，2例通过挽救性喉切除术控制了疾病。2例环状软骨和杓状软骨硬化患者尽管早期接受了挽救性喉切除术，但仍死于原发癌。在14例无硬化的患者中，8例无疾病证据，2例死于疾病，4例死于并发疾病。
孤立性喉软骨硬化的T3期声门癌可通过放射治疗治愈。
