论文部分内容阅读
本文报道了在26年期间(1952～1978年)接受放疗的177例限局于真声带的表皮样癌(声带活动正常)患者的回顾性研究。认为对早期声带癌采用放疗并以手术作为后备措施是可取的治疗方法。在平均10年随访期间,95%的病人存活,90%的嗓音保存,96%肿瘤控制。Mittal曾谈到,手术虽能得到同样好的生存率,但常要牺牲嗓音,而放疗则可保全嗓音,即使放疗失败后行半喉切除术,亦常能保存嗓音。此外,放疗花费少,病休期亦短。 177例中,147例一侧声带受累,30例双侧受累;开始治疗时无颈淋巴结或远处转移者。照射只限于喉部,照射野大小不同,但大多为5×5cm。最初用放疗不能控制病情的30例中,21例T1A有11例行半喉切除术;10例作了全喉切除。7例T1B作全喉切除术。1例T1A行颈廓清,1例仅采取了姑息疗法。
This article presents a retrospective study of 177 patients with epidermal carcinoids (normal vocal cords) limited to true vocal cords who received radiotherapy during the 26-year period (1952-1978). It is considered that the use of radiotherapy for early vocal cord cancer and surgery as a backup measure is a desirable treatment. During an average 10-year follow-up period, 95% of the patients survived, 90% of the voices were preserved, and 96% of the tumors were controlled. Mittal once said that although surgery can achieve the same good survival rate, it is often sacrificed and radiotherapy can preserve the voice. Even if the radiotherapy fails to undergo a half-laryngectomy, it can often save the voice. In addition, radiotherapy costs less and the duration of sickness is shorter. Of the 177 patients, 147 were involved in the lateral vocal cords and 30 were bilaterally involved; no cervical lymph nodes or distant metastases were initiated at the time of treatment. Irradiation is limited to the throat, and the size of the field is different, but most of them are 5×5cm. Of the 30 cases that initially failed to control the disease with radiotherapy, 11 cases of T1A underwent partial laryngectomy and 10 cases underwent total laryngectomy. Seven patients underwent total laryngectomy for T1B. One patient underwent cervical dissection in T1A, and one patient only took palliative care.