Radiotherapy After Laser Debulking Surgery for GlotticT1 Carcinoma Conserving Vocal Function

概要

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Glottic T1 carcinoma is nowadays successfully treated and its three-year survival rate is almost 100% in any treatment modalities. However, its local control rate and larynx conservation rate are still around 90%. As for vocal function, after laser surgery it is considerably worse than after radiotherapy. Since 1991 in Kurume University Hospital, a laser debulking surgery prior to radiotherapy has been indicated in selected cases whose lesions grew exophitically, in order to get both better local control rate and better post-therapeutic vocal function. In this paper this technique is described in detail and its outcome was reported. The lesion is first vaporized with the use of a CO2 laser until the affected vocal fold becomes normal in shape, followed by full-dose irradiation. Care must be taken not to vaporize too much. 15 cases with T1a carcinoma and 19 cases with T1b carcinoma underwent this treatment modality between 1991 and 1997. As a result, their local control rate was superior to both that after laser surgery and that after radiotherapy. In addition, their vocal functions were a little bit worse than those after radiotherapy and considerably better than those after laser surgery. These results suggest that this radiotherapy after a laser debulking surgery definitely improves the local control rate, conserving better vocal functions.
The Japan Laryngological Associationの論文