声門癌声門下進展例の治療方針-T2症例を中心に-

Abstract

Over a 16-year period, from 1980 though 1995, 41 patients with T2 glottic squamous cell carcinoma (SCC) with subglottic extension were treated at the National Cancer Center Hospital. The treatment modalities included radiotherapy, partial laryngectomy (P.L), and total laryngectomy (TL). The treatment results were analyzed to determine a strategy for management of T2 glottic SCC with subglottic extension.The indication of radiotherapy in these patients was limited in cases with superficial and small subglottic extension. TL was required in a majority of the patients with recurrent carcinoma after radiotherapy. TL should be initially required for patients with invasion of cricothyroid ligament and with subglottic extension over 1cm in diameter at the posterior part of the vocal cord. PL was the first choice of the treatment in a majority of the patients without superficial and small subglottic extension nor invasion of cricothyroid ligament. The local control rates and the laryngeal preservation rates were 70% and 70% with PL, versus 40% and 50% with radiotherapy. The correct diagnosis of subglottic extension via long laryngo-bronchofiberscope was very important to determine the modality of treatment.