喉頭癌114例の臨床的検討

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Based upon our policy for treatment of laryngeal cancer, a clinical study was performed on 114patients with laryngeal cancer who had been treated at our facility. Our policy is as follows: 1)primarily curative radiation (60 Gy) is indicated for T1and T2tumors. When tumor remnant is found, a total or partial laryngectomy is performed in accordance with the degree of tumor invasion; 2)preoperative radiation followed by partial or total laryngectomy is performed for T3 and T4tumors. When radiation is very effective, curative radiation may be indicated. The patients included 108 males and 6 females, whose age ranged from 39 to 80 years old with a peak occurence rate in the sixties. Glottic cancer was present in 76 cases, supraglottic cancer in 36 cases and subglottic cancer in only 2 cases. Regarding tumor size,25 cases were classified as T1,18 as T2,31 as T3 and 2as T4 among the glottic cancer group. On the other hand,11 were T1,8 were T2. 12 were T3 and 5were T4in the supraglottic cancer group. At the initial examination, the incidence of cervical lymphnode metastasis was nearly five times higher among the supraglottic cases than the glottic cases. Although curative radiation therapy (60 Gy) was carried out in 60 of the glottic cancer cases,21 of these patient needed further surgical treatment due to the tumor remnant, and preoperative radiation therapy (40 Gy) was performed in 16 cases. Whereas in supraglottic cases, curative radiation therapy was carried out in 29 cases, but in 19 cases surgical treatment were performed due to tumor remnant. Based upon the classification of disease stage,5-year survival rate, excluding the cases which had other causes of death, was 95% in stage I patients,83% in stage II,66% in stage IIi and in 43% in stage IV in the glottic cancer group. In cases with supraglottic cancer,75% were in stage I,100% in stage II,86% in stage III and 39% in stage IV. The overall 5-year survival rate was 76%. In 17 cases (15%) other malignant tumors were found.
耳鼻咽喉科臨床学会の論文

喉頭癌114例の臨床的検討

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