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Persistent Tracheostomy after Organ Preservation Protocol in Patients Treated for Larynx and Hypopharynx Cancer

机译:喉癌和下咽癌患者接受器官保存后的永久气管切开术

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摘要

>Introduction  Squamous cell carcinoma of the larynx is currently the second most common malignancy of the airway after lung cancer, and hypopharyngeal cancer accounts for fewer than 5% of head and neck cancers. The nonsurgical options for patients with this disease are related to significant long-term toxicities and the need for persistent tracheostomy, which adversely affects the quality of life of these patients. >Objective  To evaluate the need for tracheostomy, and the influence of this in the overall and specific survival rates of patients diagnosed with all stages of laryngeal carcinoma treated by chemoradiotherapy. >Methods  A retrospective study of patients diagnosed with laryngeal carcinoma was performed according to the criteria of the Union for International Cancer Control (UICC) and the American Joint Committee on Cancer (AJCC) 7th edition, in a tertiary hospital. >Results  A total of 21 patients were evaluated, 8 patients required a tracheotomy (31%) during the treatment protocol, 7 (35%) men and 1 (100%) women. According to subsite 4/4 patient with glottis cancer (p ≤ 0.001), 2/10 patients with supra glottis cancer and 2/7 patients with hypopharyngeal cancer. During follow up, just in 1 patient was possible to close the tracheostomy. >Conclusion  Persistent tracheostomy dependence after primary chemoradiation increases significantly the morbidity, and decreases the quality of life of those patients. Patients with glottis cancer are prone to need a tracheostomy, but no statistical difference regarding the oncological stage and the need for a tracheostomy were detected. A more thorough selection of the patients is needed to improve the quality of life and reduce permanent tracheostomy dependence.
机译:>简介 currently喉鳞状细胞癌是目前仅次于肺癌的第二常见气道恶性肿瘤,咽下癌仅占头颈癌的5%以下。患有这种疾病的患者的非手术选择与长期毒性和持续气管切开术的需求有关,这对这些患者的生活质量产生了不利影响。 >目的评估进行气管切开术的必要性及其对经放化疗治疗的所有阶段喉癌患者的总体生存率和特定生存率的影响。 >方法根据三级医院的国际癌症控制联盟(UICC)和美国癌症联合委员会(AJCC)第七版的标准,对诊断为喉癌的患者进行回顾性研究。 。 >结果总共评估了21例患者,在治疗方案中需要气管切开术的有8例(31%),男性为7例(35%),女性为1例(100%)。根据4/4位患有声门癌的患者(p≤0.001),2/10位声门上癌和2/7位下咽癌的患者。在随访过程中,仅1例患者就可以关闭气管造口术。 >结论 primary初次化学放疗后持续气管切开术的依赖会显着增加这些患者的发病率,并降低其生活质量。声门癌患者倾向于进行气管切开术,但未发现关于肿瘤学阶段和需要进行气管切开术的统计学差异。需要对患者进行更彻底的选择,以改善生活质量并减少永久性气管切开术的依赖性。

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