Gripp S, Pape H, Schmitt G
Department of Radiation Oncology, Heinrich-Heine-University Duesseldorf, Germany.
Cancer. 1998 Jan 1;82(1):108-15. doi: 10.1002/(sici)1097-0142(19980101)82:1<108::aid-cncr13>3.0.co;2-6.
Experience in the treatment of laryngeal chondrosarcoma is based on about 250 cases reported to date. The standard therapy is conservative surgery. Radiotherapy has universally been regarded as ineffective in the treatment of this disease.
A patient with a laryngeal chondrosarcoma was observed for 11 years after radical radiotherapy. The literature on laryngeal chondrosarcoma was critically reviewed, with emphasis placed on radiotherapy.
The review of the literature revealed that experience with radiotherapy of laryngeal chondrosarcoma has been lacking, with fewer than 10 cases with short follow-up documented up to now. Meanwhile, increasing evidence of the efficacy of radiotherapy in the treatment of skeletal chondrosarcoma has emerged. The authors report the first case of chondrosarcoma of the larynx in which radical radiotherapy resulted in a long term remission of more than 10 years.
Radiotherapy should be considered when radical surgery is not feasible without severe mutilation. It should also be considered for the treatment of residual disease. Laryngectomy should be restricted to salvage treatment when radiotherapy fails. In this study, radiotherapy appeared to be an effective modality in the treatment of low grade laryngeal chondrosarcoma, and these results contrast with the current widespread disapproval of this treatment.
目前喉软骨肉瘤的治疗经验基于迄今报道的约250例病例。标准治疗方法是保守手术。放射治疗一直被普遍认为对这种疾病无效。
对一名喉软骨肉瘤患者进行根治性放疗后观察了11年。对喉软骨肉瘤的文献进行了严格审查，重点是放射治疗。
文献综述显示，目前缺乏喉软骨肉瘤放射治疗的经验，到目前为止记录在案的随访时间短的病例不到10例。与此同时，越来越多的证据表明放射治疗对骨软骨肉瘤的治疗有效。作者报告了首例喉软骨肉瘤病例，其中根治性放疗导致了超过10年的长期缓解。
当根治性手术不可行且不会造成严重致残时，应考虑放射治疗。对于残留疾病的治疗也应考虑放射治疗。当放射治疗失败时，喉切除术应限于挽救性治疗。在本研究中，放射治疗似乎是治疗低级别喉软骨肉瘤的有效方式，这些结果与目前对这种治疗方法的普遍不认可形成了对比。
