声門癌におけるレーザー治療の検討

Abstract

From January 1982 to February 1987, 14 patients of glottic cancer were treated with CO2 laser at Department of Otolaryngology, Saga Medical School. The purpose of this study is evaluated that the application of CO2 laser surgery for glottic cancer. The results are summarized as follows;1) Three patients with Tis and T1a were treated only by CO2 laser vaporization under endolaryngeal microscopy. The selesions were located in the membranous portion of the vocalcords apart from both anterior commissure and vocal process. None of them had recurrences following surgery.2) On the other hand, we employed combination therapy with laser and radiation for 9 cases. Among these cases, three were T1a with bulky tumors and/or with tumors involved entire membranous portion of the vocal cords, and 6 were T1b. Three cases in T1b were suffered from residual lesions and recurrent tumor safter radiation. Therefore, cordectomy using laser was perormed in one case and observed without recurrence, finally total laryngectomy were performed in the other 2 cases.3) Selected two cases in glottic T2 were treated with combination therapy of laser surgery and radiotherapy. After treatment, no recurrence has been observed in one case, but the other cases died of local recurrence and distant metastasis. From our experience, independent laser surgery is indicated only in selected cases of Tis and T1a as described as above.