保留喉功能的梨状窝癌的综合治疗

Laryngeal function preservation in comprehensive therapy of carcinoma of pyriform sinus

目的 :探讨综合治疗对保留喉功能的梨状窝癌的作用。方法 :对梨状窝癌进行保留喉功能治疗的 33例进行回顾性分析。 133例术前分别给予 1周期或 2周期诱导化疗 ;2手术治疗经化疗后的肿瘤切除 ;3术后放射治疗。结果 :化疗后有效率 42 .4%。 3年生存率 5 4.8% ,5年生存率 38.7%。有 2 1例全部恢复了喉功能 ,12例恢复部分喉功能。结论 :以顺铂为主的联合化疗方案对梨状窝癌是安全有效的 ,术前诱导化疗可提高梨状窝癌的手术切除率及喉功能保留率 ,化疗后的肿瘤切除不仅不增加局部复发率 ,而且能提高喉功能的保留率 ,手术后放疗还能提高局部控制率 。

Objective: To investigate the sufficiency of comprehensive therapy in the preservation of laryngeal function of carcinoma of pyriform sinus.Method:Since 1986, 33 cases of pyriform sinus carcinoma were treated , the clinical stages were as follows: stage Ⅰ2 cases, stage Ⅱ 9 cases , stage Ⅲ 12, stage Ⅳ 10. The induced chemotherapy agents were cisplatin, methotrexate and pingyangmycin. Surgical treatment include local dissection of tumor, partial hypopharynx and partial larynx dissection. All patients were received postoperative radiotherapy.Result:Chemotherapy partial response rate was 42.4%, 3 years survive rate was 54.8 %, 5 years survive rate was 38.7 %.Conclusion:The cisplatin centered combined induced chemotherapy was effective in the treatment of pyriform sinus, the laryngeal function preservation surgical treatment of pyriform sinus carcinoma in T 1 T 2 and selective T 3 patients is practicable . Postoperative radiotherapy can improve the local control rate.