喉保存后声带功能恢复与无复发概率相关
Dauren Adilbay1, Ameya A Asarkar1,2, Rema Anisha Kandula1
1Department of Otolaryngology and Head Neck Surgery, Louisiana State University of Health Sciences, Shreveport, Louisiana, U.S.A.
The Laryngoscope
|July 1, 2024
概括
在喉癌治疗后恢复声带运动至关重要. 持久声带不运动的患者面临更高的局部复发风险,需要更密切的监测,以便早期检测.
科学领域:
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 在瘤学瘤学.
- 喉癌研究 喉癌研究
背景情况:
- 声带固定是喉癌的关键分期因素.
- 之前的回顾性研究表明,化学放射治疗后的声带运动恢复是有利的预后指标.
研究的目的:
- 为了前性地评估声带运动恢复在最终喉癌治疗后的预后意义.
- 为了确定声带运动恢复是否会影响局部复发和生存率.
主要方法:
- 对30名患有喉平细胞癌 (T2/3,T4a) 和声带损伤/固定的患者进行前性队列研究.
- 化学辐射疗法是最终的治疗方法.
- 视频喉腔镜评估了治疗前和治疗后3个月的声带流动性.
- 主要终点:局部无复发概率;次要终点:无复发概率,疾病特异性存活率 (DSS) 和整体存活率 (OS).
主要成果:
- 60%的患者 (18/30) 实现了完全的声带运动恢复;40% (12/30) 有持续的损伤/固定.
- 经过五年时间的局部无复发概率在受损组 (46%) 与恢复移动性的组 (85%) (p=0.012) 相比显著更差.
- 恢复声带流动性是局部无复发概率 (HR 6.15) 的重要预测因素.
结论:
- 声带移动性恢复的缺失与喉保护治疗后局部无复发概率较差有关.
- 患有持续声带不运动的患者需要警的随访,以便早期检测复发.
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