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作 者:谢冰斌[1] 黄冠江 张靖萱 刘月辉[1] 刘红兵[1]
机构地区:[1]南昌大学第二附属医院耳鼻咽喉-头颈外科,南昌330006
出 处:《实用临床医学(江西)》2016年第10期51-54,共4页Practical Clinical Medicine
基 金:江西省卫生计生委科技计划项目(20155258)
摘 要:目的探讨经口激光显微手术(transoral laser microsurgery,TLM)治疗复发性喉癌的临床疗效。方法对31例复发性喉癌患者采用TLM治疗。观察31例患者术后2、5年总生存率、无瘤生存率,肿瘤累及前联合、肿瘤未累及前联合和临床分期为Ⅰ期、Ⅱ期的5年肿瘤局部控制率,保留喉功能、吞咽功能,再复发的情况。结果 31例患者中,全喉保留率为90.3%(28/31)。术后2年总生存率和无瘤生存率分别为90.3%、74.2%,术后5年总生存率和无瘤生存率分别为76.0%、64.1%。肿瘤累及前联合和肿瘤未累及前联合的术后5年肿瘤局部控制率分别为41.7%、78.6%,肿瘤累及前联合的术后5年肿瘤局部控制率低于肿瘤未累及前联合(P<0.05)。31例患者均保留喉功能及吞咽功能。22例未复发,9例再复发。结论 TLM治疗复发性喉癌可获得较好的疗效,能够提高患者的术后生存率和无瘤生存率及生存质量。Objective To investigate the clinical effect of transoral laser microsurgery(TLM) on recurrent laryngeal cancer.Methods Thirty-one patients with recurrent laryngeal cancer were treated with TLM.The postoperative two-year and 5-year overall survival rates and cancer-free survival rate were recorded.In addition,locoregional control,laryngeal function preservation, swallowing function and recurrence were observed in patients with or without anterior commis-sure involvement.Results Among the 31 patients,larynx preservation rate was 90.3%(28/31). The postoperative 2-year overall survival rate and cancer-free survival rate was 90.3% and 74.2%,re-spectively.The postoperative 5-year overall survival rate and cancer-free survival rate was 76.0%and 64.1%,respectively.The postoperative 5-year locoregional control rate in patients with ante-rior commissure involvement(41.7%)was lower than that in patients without anterior commis-sure involvement(78.6%)(P 〈0.05).Laryngeal function and swallowing function were preserved in all of the 31 patients.Nine of 31 patients had a second recurrence.Conclusion TLM can in-crease postoperative survival rate,cancer-free survival rate and quality of life in patients with re-current laryngeal cancer.
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