摘要:

All tumor classifications are compromises based upon clinical or radiological evaluation with little concern for histology and intrinsic errors in application. Laryngeal cancer is no exception, and the present UICC system is critically examined with the intention of highlighting such deficiencies and relating them where possible to prognosis. Possible lymph node and systemic metastases are also considered in the light of personal experience and any intrinsic weaknesses evaluated in relation to variations in published cure rates. No better system is proposed, for at least this system encourages more accurate recording of clinical assessment.

ISSN:0301-1569    

DOI:10.1159/000275443

出版商:S. Karger AG    

年代:1979

数据来源: Karger

摘要:

Chemoradiotherapy is an established method in the therapeutic management of incurable laryngeal and pharyngeal carcinomas or recurrences. On principle two different schedules of chemoradiotherapy are available: (1) the synchronization therapy (irradiation subsequent to a subtoxic dose of 5-fluorouracil) and (2) the combined treatment with bleomycine and X-rays. The results of cell kinetic studies which have fundamentally contributed to our knowledge and understanding of these therapeutic schedules are discussed and the clinical results are demonstrated. The conclusion is drawn that the chemoradiotherapy cannot and shall not substitute the proved methods of surgery and radiotherapy. But in hopeless cases it lengthens the survival time and diminishes the excruciating pain of the tumor patient.

ISSN:0301-1569    

DOI:10.1159/000275444

出版商:S. Karger AG    

年代:1979

数据来源: Karger

摘要:

Difficult indications for certain partial laryngectomies are presented. Anatomically, the difficulties stem from the thyroid cartilage and from the paraglottic space in which invasion (difficult to determine) is contradictory for partial surgery. The principal objective is the cure of the laryngeal cancer all in maintaining laryngeal function. The surgeon must conserve a ‘minimal arytenoid unit’ (the whole formed by the pharyngoepiglottic fold, the aryepiglottic fold, the arytenoid and the corresponding cord). Other difficulties not carcinogenic are found: physical conditions, social and professional situation, and preexisting local problems (associated laryngocel or previous vocal palsy). Finally, carcinogenic difficulties can be seen: the situation of the tumor, the rapidity of its evolution, anatomopathologic type, presence of nodes and metastases and previous physiotherapy and chemother

ISSN:0301-1569    

DOI:10.1159/000275445

出版商:S. Karger AG    

年代:1979

数据来源: Karger

摘要:

Cryosurgery of the larynx is still in the stage of development. In the treatment of laryngeal papillomas cryosurgery has been quite successful. The use of cryosurgery in laryngo-hypopharyngeal carcinoma and in laryngeal stenosis is still restricted to special indications (old age, risk patients). A combination of cryosurgery and telecobalt irradiation has proven valuable in the management of tumors. After the basic physics of laser radiation are explained, the principle mechanisms of interaction between the CO2 laser on human tissue are mentioned. This is followed by the description of the different indications for laser surgery in the larynx. A chordectomy and the opening of a subglottic stenosis with the laser beam are described and documented with photographs. Finally, there is an outlook to an eventually broader spectrum of indications for laser surgery in the field of ENT.

ISSN:0301-1569    

DOI:10.1159/000275446

出版商:S. Karger AG    

年代:1979

数据来源: Karger

摘要:

A report is given of the follow-up and behavior of 149 supraglottic squamous carcinomas treated by combined radiosurgical therapy. In 27 cases supraglottic laryngectomy and in 4 cases epiglottectomy was performed. The other cases underwent laryngectomy. The 3-year survival rate was 60% and the 5-year survival rate 51.2%. 64% of the patients without nodular metastases and 45% of the patients with histologically ascertained nodular metastases survived the 3-year interval. The main localizations of the supraglottic tumors are compared with the tendency to spread into unilateral, homolateral, contralateral or bilateral sites, respectively. A comparative study by serial sectioning of 51 supraglottic squamous carcinomas shows that the tendency to nodular metastases increases with decreasing differentiation of the tumor.

ISSN:0301-1569    

DOI:10.1159/000275447

出版商:S. Karger AG    

年代:1979

数据来源: Karger

摘要:

At most interdisciplinary tumour centres, radiotherapy is of prime importance in the concept of therapy for the majority of the cases of laryngeal carcinoma treated, or it is even employed – exploratively and with curative intent – as the sole therapy at first. At all events initial radiotherapy occupies a dominant position today. Against this background the question is often discussed whether, after a ‘low dose’ has been attained (particularly in the case of a supraglottic tumour), a partial or total laryngectomy should be performed or the radiation dose substantially increased with the aim of obtaining a cure. However, the difficulties involved immediately after irradiation or later in recognizing a persistent or recurrent carcinoma and readily identifying it histologically may be very great. Various aspects of such situations – both diagnostic and therapeutic – are dicussed in general and with reference to cas

ISSN:0301-1569    

DOI:10.1159/000275448

出版商:S. Karger AG    

年代:1979

数据来源: Karger

ISSN:0301-1569    

DOI:10.1159/000275449

出版商:S. Karger AG    

年代:1979

数据来源: Karger