Background: This is a retrospective study on a group of patients with early glottic carcinoma, treated with curative radiotherapy. The aim of the study is to assess voice quality after treatment. We also evaluated loc...Background: This is a retrospective study on a group of patients with early glottic carcinoma, treated with curative radiotherapy. The aim of the study is to assess voice quality after treatment. We also evaluated local recurrence, overall survival, disease free survival and toxicity. Material and Methods: We examined a total of 36 patients, out of which 27 were smokers: 10 females/5 smokers;26 males/22 smokers. The sample was observed from January 2007 to July 2012 (average follow-up period: 33.5 months, range 12 - 76). Diagnosis of early glottic carcinoma was eight during the two-year period 2007/2008, nine during 2009/2010, eleven during year 2011 and eight during year 2012. All patients suffering from early glottic carcinoma, histopathologically confirmed, were classified as follows: 24 patients T1a, 3 patients T1b, 6 patients T2 and 3 patients had a carcinoma in situ. They were treated only with conventional radiotherapy. After the treatment (total dose 70 Gy), patients were asked to fill out the Voice Handicap Index (VHI) questionnaire, composed of 30 questions that covered physical, emotional and functional areas. Results: The global VHI was evidenced with good voice quality (62% of patients: VHI < 30;34% of patients: VHI 31 - 60). Vocal disability was mild in over 70% of patients within the physical area and over 80% within the emotional area. We observed two local recurrences, one occurred five years after the end of radiation therapy and one six months after. In terms of toxicity, we observed that acute reactions, such as dysphonia, dysphagia and erythema, were relatively limited. Conclusions: The VHI index suggests that radiotherapy produces acceptable functional results, with limited repercussion on life quality. In line with literature, our data confirmed good cure rates and larynx preservation (94.4%).展开更多
The aims of this study were to evaluate the results of CO2 laser surgery alone and CO2 laser surgery combined with radiotherapy in patients with T2N0M0 glottic carcinoma. A retrospective analysis was conducted of 35 c...The aims of this study were to evaluate the results of CO2 laser surgery alone and CO2 laser surgery combined with radiotherapy in patients with T2N0M0 glottic carcinoma. A retrospective analysis was conducted of 35 cases of T2N0M0 glottic carcinoma. Fourteen patients with normal vocal cord mobility were treated with endoscopic CO2 laser surgery alone. The remaining 21 patients were treated with CO2 laser surgery followed by radiotherapy (44 - 70 Gy, including low-dose carboplatin chemoradiotherapy). Main outcome measures were local control, organ preservation, recurrence, 5-year survival, and successful salvage in cases of recurrence. We evaluated the patient’s voice with the psychoacoustics GRBAS scale, maximum phonation time (MPT), and airflow rate (AFR) obtained by aerodynamic tests. Mean follow-up period was 5 years. Among the 35 T2N0M0 patients, 5-year survival and 5-year voice preservation rates were 97% and 89%, respectively. Local recurrence occurred in 7 of these patients (20%);4 of 7 local recurrences were successfully re-treated by laser surgery. Total laryngectomy was necessary for salvage treatment in the remaining 3 patients. The post-treatment voice qualities were judged to be the same or improved over pretreatment qualities. There was little change in MPT and AFR after treatment in non-recurrence patients. CO2 laser microsurgery is an excellent tool for treating selected cases of T2N0M0展开更多
Background: The current treatment options of early glottic carcinoma are radiotherapy;trans laser microsurgery, and open surgery. However, the best treatment is still controversial due to lack of randomized controlled...Background: The current treatment options of early glottic carcinoma are radiotherapy;trans laser microsurgery, and open surgery. However, the best treatment is still controversial due to lack of randomized controlled trials. We aimed to evaluate the treatment results and the prognostic factors of local control of early glottic squamous cell carcinoma patients (GSCC) T1-2N0M0 treated at our institution. Material and Methods: We retrospectively studied the charts of 52 patients with early GSCC T1-T2N0M0 from 2010-2015 at the Clinical Oncology Department, Ain-Shams University. 24 patients had T1 and 28 had T2 early glottic carcinoma. The overall survival OS, local control rate, and laryngeal preservation rate were evaluated. Kaplan-Meier method, Cox proportional hazards model were used to analyze the data. Results: Median duration of follow-up was 13 months. Thirty-eight patients received radiation treatment alone (73.1%), 7.7% of the patients underwent surgery alone, and 19.2% of the patients had surgery combined with radiotherapy. Local recurrence after radiation failure developed in 6/52 patients, all had T2 disease and were salvaged by total laryngectomy. The ultimate local control rate was 88.5%, and the ultimate laryngeal preservation rate was 77.2% (40/52 patients). The median OS of the 52 patients was 13 months (range 2 - 46 months). Univariate analysis of factors associated with poor local control showed that age > 60 years was the only significant factor (P = 0.048). Conclusion: Radiotherapy achieves high local control and laryngeal preservation rates for patients with early glottic carcinoma, and is associated with a low rate of severe complications compared to surgery. Salvage surgery is feasible after radiotherapy failure.展开更多
目的比较等离子射频消融术与CO_(2)激光治疗早期声门型喉癌(EGC)的效果。方法根据治疗方法的不同将80例EGC患者分为对照组(n=40,CO_(2)激光)与研究组(n=40,等离子射频消融术),比较两组患者的围手术期指标[手术时间、术中出血量、术后住...目的比较等离子射频消融术与CO_(2)激光治疗早期声门型喉癌(EGC)的效果。方法根据治疗方法的不同将80例EGC患者分为对照组(n=40,CO_(2)激光)与研究组(n=40,等离子射频消融术),比较两组患者的围手术期指标[手术时间、术中出血量、术后住院时间、术后24 h视觉模拟评分法(VAS)评分]、嗓音功能[振幅微扰、谐噪比(HNR)、基频微扰]、生活质量[嗓音障碍指数(VHI)]、吞咽功能[电视透视吞咽功能检查(VFSS)]、局部复发情况及并发症发生情况。结果研究组患者手术时间、术后住院时间均明显短于对照组,术中出血量明显少于对照组,术后24 h VAS评分明显低于照组,差异均有统计学意义(P﹤0.01)。术后4周,两组患者HNR均高于本组术前,基频微扰、振幅微扰均低于本组术前,研究组患者HNR高于对照组,基频微扰、振幅微扰均低于对照组,差异均有统计学意义(P﹤0.05)。术后6个月,两组患者VHI评分均低于本组术前,VFSS评分均高于本组术前,研究组患者VHI评分低于对照组,VFSS评分高于对照组,差异均有统计学意义(P﹤0.05)。研究患者的局部复发率和并发症总发生率均低于对照组,但差异均无统计学意义(P﹥0.05)。结论与CO_(2)激光相比,等离子射频消融术治疗EGC的效果更好,可以缩短手术时间,减少术中出血量,减轻术后疼痛感,同时对患者嗓音、吞咽功能的影响较小,可以促进患者术后快速康复,并且提高生活质量。展开更多
目的比较低温等离子射频消融术与CO2激光治疗早期声门型喉癌的临床疗效。方法选取2007年10月~2012年12月行手术治疗的104例早期声门型喉癌（Tis、T1a、T1b）患者,其中64例行低温等离子射频消融术（等离子组）,40例行CO2激光切除术（CO2...目的比较低温等离子射频消融术与CO2激光治疗早期声门型喉癌的临床疗效。方法选取2007年10月~2012年12月行手术治疗的104例早期声门型喉癌（Tis、T1a、T1b）患者,其中64例行低温等离子射频消融术（等离子组）,40例行CO2激光切除术（CO2激光组）。记录并比较两组手术时间、术后第二日疼痛程度[视觉模拟评分法（visual analog scale,VAS）]评分;所有患者于术后一周、1个月及3个月行电子喉镜及嗓音声学分析,并进行随访观察。结果等离子组平均手术时间为8.75±1.62min,CO2激光组平均手术时间为11.82±1.51min,等离子组优于CO2激光组（P〈0.05）。术后第二日VAS评分等离子组（2.79±0.47分）与CO2激光组（2.96±0.64分）组间差异无统计学意义（P〉0.05）。等离子组术后1个月粘膜恢复情况好于CO2激光组（χ2=13.842,P〈0.05）。单因素重复测量分析结果显示：等离子组及CO2激光组术后嗓音声学指标jitter、shimmer、HNR随术后时间延长逐渐好转,在术后3个时间点的变化差异有统计学意义（P〈0.05）,且呈线性变化趋势。多因素重复测量方差分析结果显示：嗓音声学指标（jitter、shimmer、HNR）在术后3个时间点两组间差异均有统计学意义（P〈0.05）。等离子组与CO2激光组术后3年生存率、局部复发率、侵及前联合复发率、前联合术后粘连率组间差异均无统计学意义（P〉0.05）。两组所有患者均未行气管切开术,术后无呛咳,无呼吸困难,无严重疼痛及咯血等严重并发症。结论低温等离子射频消融术与CO2激光治疗早期声门型喉癌均较安全、有效,而低温等离子射频消融术手术时间较CO2激光手术短,术后一月粘膜恢复及嗓音恢复均优于CO2激光手术。展开更多
文摘Background: This is a retrospective study on a group of patients with early glottic carcinoma, treated with curative radiotherapy. The aim of the study is to assess voice quality after treatment. We also evaluated local recurrence, overall survival, disease free survival and toxicity. Material and Methods: We examined a total of 36 patients, out of which 27 were smokers: 10 females/5 smokers;26 males/22 smokers. The sample was observed from January 2007 to July 2012 (average follow-up period: 33.5 months, range 12 - 76). Diagnosis of early glottic carcinoma was eight during the two-year period 2007/2008, nine during 2009/2010, eleven during year 2011 and eight during year 2012. All patients suffering from early glottic carcinoma, histopathologically confirmed, were classified as follows: 24 patients T1a, 3 patients T1b, 6 patients T2 and 3 patients had a carcinoma in situ. They were treated only with conventional radiotherapy. After the treatment (total dose 70 Gy), patients were asked to fill out the Voice Handicap Index (VHI) questionnaire, composed of 30 questions that covered physical, emotional and functional areas. Results: The global VHI was evidenced with good voice quality (62% of patients: VHI < 30;34% of patients: VHI 31 - 60). Vocal disability was mild in over 70% of patients within the physical area and over 80% within the emotional area. We observed two local recurrences, one occurred five years after the end of radiation therapy and one six months after. In terms of toxicity, we observed that acute reactions, such as dysphonia, dysphagia and erythema, were relatively limited. Conclusions: The VHI index suggests that radiotherapy produces acceptable functional results, with limited repercussion on life quality. In line with literature, our data confirmed good cure rates and larynx preservation (94.4%).
文摘The aims of this study were to evaluate the results of CO2 laser surgery alone and CO2 laser surgery combined with radiotherapy in patients with T2N0M0 glottic carcinoma. A retrospective analysis was conducted of 35 cases of T2N0M0 glottic carcinoma. Fourteen patients with normal vocal cord mobility were treated with endoscopic CO2 laser surgery alone. The remaining 21 patients were treated with CO2 laser surgery followed by radiotherapy (44 - 70 Gy, including low-dose carboplatin chemoradiotherapy). Main outcome measures were local control, organ preservation, recurrence, 5-year survival, and successful salvage in cases of recurrence. We evaluated the patient’s voice with the psychoacoustics GRBAS scale, maximum phonation time (MPT), and airflow rate (AFR) obtained by aerodynamic tests. Mean follow-up period was 5 years. Among the 35 T2N0M0 patients, 5-year survival and 5-year voice preservation rates were 97% and 89%, respectively. Local recurrence occurred in 7 of these patients (20%);4 of 7 local recurrences were successfully re-treated by laser surgery. Total laryngectomy was necessary for salvage treatment in the remaining 3 patients. The post-treatment voice qualities were judged to be the same or improved over pretreatment qualities. There was little change in MPT and AFR after treatment in non-recurrence patients. CO2 laser microsurgery is an excellent tool for treating selected cases of T2N0M0
文摘Background: The current treatment options of early glottic carcinoma are radiotherapy;trans laser microsurgery, and open surgery. However, the best treatment is still controversial due to lack of randomized controlled trials. We aimed to evaluate the treatment results and the prognostic factors of local control of early glottic squamous cell carcinoma patients (GSCC) T1-2N0M0 treated at our institution. Material and Methods: We retrospectively studied the charts of 52 patients with early GSCC T1-T2N0M0 from 2010-2015 at the Clinical Oncology Department, Ain-Shams University. 24 patients had T1 and 28 had T2 early glottic carcinoma. The overall survival OS, local control rate, and laryngeal preservation rate were evaluated. Kaplan-Meier method, Cox proportional hazards model were used to analyze the data. Results: Median duration of follow-up was 13 months. Thirty-eight patients received radiation treatment alone (73.1%), 7.7% of the patients underwent surgery alone, and 19.2% of the patients had surgery combined with radiotherapy. Local recurrence after radiation failure developed in 6/52 patients, all had T2 disease and were salvaged by total laryngectomy. The ultimate local control rate was 88.5%, and the ultimate laryngeal preservation rate was 77.2% (40/52 patients). The median OS of the 52 patients was 13 months (range 2 - 46 months). Univariate analysis of factors associated with poor local control showed that age > 60 years was the only significant factor (P = 0.048). Conclusion: Radiotherapy achieves high local control and laryngeal preservation rates for patients with early glottic carcinoma, and is associated with a low rate of severe complications compared to surgery. Salvage surgery is feasible after radiotherapy failure.
文摘目的比较等离子射频消融术与CO_(2)激光治疗早期声门型喉癌(EGC)的效果。方法根据治疗方法的不同将80例EGC患者分为对照组(n=40,CO_(2)激光)与研究组(n=40,等离子射频消融术),比较两组患者的围手术期指标[手术时间、术中出血量、术后住院时间、术后24 h视觉模拟评分法(VAS)评分]、嗓音功能[振幅微扰、谐噪比(HNR)、基频微扰]、生活质量[嗓音障碍指数(VHI)]、吞咽功能[电视透视吞咽功能检查(VFSS)]、局部复发情况及并发症发生情况。结果研究组患者手术时间、术后住院时间均明显短于对照组,术中出血量明显少于对照组,术后24 h VAS评分明显低于照组,差异均有统计学意义(P﹤0.01)。术后4周,两组患者HNR均高于本组术前,基频微扰、振幅微扰均低于本组术前,研究组患者HNR高于对照组,基频微扰、振幅微扰均低于对照组,差异均有统计学意义(P﹤0.05)。术后6个月,两组患者VHI评分均低于本组术前,VFSS评分均高于本组术前,研究组患者VHI评分低于对照组,VFSS评分高于对照组,差异均有统计学意义(P﹤0.05)。研究患者的局部复发率和并发症总发生率均低于对照组,但差异均无统计学意义(P﹥0.05)。结论与CO_(2)激光相比,等离子射频消融术治疗EGC的效果更好,可以缩短手术时间,减少术中出血量,减轻术后疼痛感,同时对患者嗓音、吞咽功能的影响较小,可以促进患者术后快速康复,并且提高生活质量。
文摘目的比较低温等离子射频消融术与CO2激光治疗早期声门型喉癌的临床疗效。方法选取2007年10月~2012年12月行手术治疗的104例早期声门型喉癌（Tis、T1a、T1b）患者,其中64例行低温等离子射频消融术（等离子组）,40例行CO2激光切除术（CO2激光组）。记录并比较两组手术时间、术后第二日疼痛程度[视觉模拟评分法（visual analog scale,VAS）]评分;所有患者于术后一周、1个月及3个月行电子喉镜及嗓音声学分析,并进行随访观察。结果等离子组平均手术时间为8.75±1.62min,CO2激光组平均手术时间为11.82±1.51min,等离子组优于CO2激光组（P〈0.05）。术后第二日VAS评分等离子组（2.79±0.47分）与CO2激光组（2.96±0.64分）组间差异无统计学意义（P〉0.05）。等离子组术后1个月粘膜恢复情况好于CO2激光组（χ2=13.842,P〈0.05）。单因素重复测量分析结果显示：等离子组及CO2激光组术后嗓音声学指标jitter、shimmer、HNR随术后时间延长逐渐好转,在术后3个时间点的变化差异有统计学意义（P〈0.05）,且呈线性变化趋势。多因素重复测量方差分析结果显示：嗓音声学指标（jitter、shimmer、HNR）在术后3个时间点两组间差异均有统计学意义（P〈0.05）。等离子组与CO2激光组术后3年生存率、局部复发率、侵及前联合复发率、前联合术后粘连率组间差异均无统计学意义（P〉0.05）。两组所有患者均未行气管切开术,术后无呛咳,无呼吸困难,无严重疼痛及咯血等严重并发症。结论低温等离子射频消融术与CO2激光治疗早期声门型喉癌均较安全、有效,而低温等离子射频消融术手术时间较CO2激光手术短,术后一月粘膜恢复及嗓音恢复均优于CO2激光手术。
