早期聲門癌以內視鏡二氧化碳雷射顯微手術治療的長期追蹤結果

Endoscopic CO2 Laser Microsurgery for Treating Early Glottic Cancer: Long-term Follow-up

王怡芬(Yi-Fen Wang) ； 徐念宗(Nen-Tzong Hsu) ； 張學逸(Shyue-Yih Chang)

《中華民國耳鼻喉科醫學會雜誌》 33卷5期 (1998/10) Pp. 494-501

https://doi.org/10.6286/1998.33.5.494

摘要

背景：使用內視鏡二氧化碳雷射顯微手術來治療早期聲門癌，已被廣為接受是一種簡單、可保存發聲機能且治癒率很高的手術。本文將我們近年來以內視鏡二氧化碳雷射顯微手術治療早期聲門癌後長期追蹤的結果作一檢討和分析。
方法：自1986年3月至1992年9月期間，我們針對20例早期聲門癌患者：包括原位癌2例，T1a聲門癌15例，T2聲門癌3例，施行內視鏡二氧化碳雷射顯微手術並術後追蹤至少62個月，以統計其復發的情形。
結果：在20例中，有2例病理報告顯示切除邊緣有腫瘤細胞，於術後加作放射線治療且追蹤期間沒有腫瘤復發；另有1例於術60個月腫瘤復發，但施行全喉切除術後得以控制病情；統計顯示5年的疾病控制率為95%，而5年存活率則為100%。
結論：我們認為內視鏡二氧化碳雷射顯微手術是治療是治療早期聲門癌一個相當理想的選擇。

關鍵字

二氧化碳雷射 ； 內視鏡聲帶切除術 ； 早期聲門癌

並列摘要

Background: In the treatment of early glottic cancer, there are many treatment options at present. Endoscopic CO2 laser microsurgery has proven to be a good treatment altenative for early glottic cancer in terms of oncological as well as functional results in a simple way.
Method: Twenty patients with early gottic cancer in the period from 1986 through 1992 jad beem treated by endocscopic CO2 laser microsurgery and followed for a minimum of 62 months.
Results: Two patients underwent postlaser surgery radiotherapy because the presence of cancer cells at the margins of the excised specimen by histopathologic examination. A local recurrence of disease developed 60 months later postoperatively in one of these patients but was successfully treated by total laryngectomy, unfortunately this patient died of small cell carcinoma of the lung 32 months laster. The 5-year disease control rate was 95% (19 of 20 patients) and the 5-year survival rate was 100% (20 of 20 patients).
Conclusions: We concluded that endoscopic CO2laser microsurgery could be a successful treatment option if careful patient selection and accurate serial histopathologic evaluation are followed.

並列關鍵字

carbon dioxide laser ； endoscopic cordectomy ； early glottic carcinoma