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著者指出:近来有人提议用CO_2激光治疗T_1声门癌,其理由是放疗的破坏性大。著者对这种主张持有异议,撰此文旨在用临床资料给以反驳。著者对4年期间行放疗的419例喉癌中属于T_1N_0M_0的208名患者从照射坏死率、治愈率和复发率方面进行了观察分析。这些患者是在21天内分15次用4百万电子伏的条件进行了5,250～5,500 r的放疗,方法是采用楔形交叉照射。结果:208例中有10例发生放射坏死,其中T_1A 6例(占146例的4%),T_1B 4例(占52例的8%),10例T_1S无坏死者。T_1A的6例中3例作了喉切除,3例需长期保留气管造口。T_1B的4例中1例未及手术即死亡,2例作了喉切除,1例长期保留气管造口。以放疗坏死为死因的只占总病死率的10%。本组208例中治疗后存活5年的占
The authors pointed out that it has recently been proposed to treat T_1 glottic cancer with a CO 2 laser because of the destructive nature of radiotherapy. The author disagreed with this claim, and his article aims to refute this with clinical data. The authors observed and analyzed the rate of irradiation necrosis, cure rate, and recurrence rate of 208 patients belonging to T_1N_0M_0 in 419 cases of laryngeal carcinoma who underwent radiotherapy for 4 years. These patients underwent radiotherapy at 5,250-5,500 rpm for 15 times with 4 million electron volts in 21 days using wedge-shaped cross-illumination. RESULTS: Radiation necrosis occurred in 10 of 208 patients, including 6 patients with T_1A (4% of 146 patients), 4 patients with T_1B (8% of 52 patients), and 10 patients without T_1S. Three out of 6 patients with T_1A had laryngectomy, and 3 required long-term retention of tracheostomy. One of the 4 patients with T_1B died without surgery, 2 had laryngectomy, and 1 had long-term retention of tracheostomy. Only 10% of the total mortality was due to radiotherapy necrosis as the cause of death. 208 cases in this group accounted for 5 years of survival after treatment