Leirens J, Vidts G, Schmelzer B, della Faille D, Katz S, Van Cauwenberge P
Department of Otorhinolaryngology, Head and Neck Surgery, Middelheimziekenhuis, Antwerp, Belgium.
Acta Otolaryngol. 1997 Nov;117(6):903-8. doi: 10.3109/00016489709114222.
A series of 62 patients treated by (repeated) CO2 laser excision and/or vaporization for premalignant lesions of the vocal cords was analysed retrospectively. Of the 54 patients available for follow-up (ranging from 1 to 15 years), five patients (9%) developed an invasive glottic carcinoma and needed radiotherapy. Only two patients (4%) needed extensive surgery (total laryngectomy). One patient (2%) died of a recurrent carcinoma despite radiotherapy and laryngectomy, and six patients (11%) died of a metachronic lung carcinoma. The therapeutic results of (repeated) laser therapy were comparable to those in other reports regarding radiotherapy or stripping. The subjective functional results were satisfactory and tended to improve along with refinement of laser surgery techniques. Follow-up of patients who once had a premalignant laryngeal lesion is mandatory ad vitam, regardless of the grade of the lesion. For the screening of lung cancer, there is still no consensus on a standard-of-care. The classical chest X-ray remains the most accessible and comfortable screening procedure.
对62例因声带癌前病变接受（重复）二氧化碳激光切除和/或汽化治疗的患者进行了回顾性分析。在可进行随访的54例患者中（随访时间为1至15年），有5例患者（9%）发生了浸润性声门癌，需要进行放疗。只有2例患者（4%）需要进行广泛手术（全喉切除术）。1例患者（2%）尽管接受了放疗和喉切除术，但仍死于复发性癌，6例患者（11%）死于转移性肺癌。（重复）激光治疗的效果与其他关于放疗或剥脱术的报告结果相当。主观功能结果令人满意，并且随着激光手术技术的改进有改善的趋势。无论喉癌前病变的分级如何，对曾患喉癌前病变的患者进行终身随访是必要的。对于肺癌筛查，目前尚无关于标准治疗方案的共识。传统的胸部X光检查仍然是最容易获得且最舒适的筛查方法。
