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早期喉癌放疗后,偶尔在长期生存者中于先前照射的喉发生第二个癌。对这种病变的处理传统上不照射,认为要超出正常喉结构的耐受量不可能完成全程放疗。但手术治疗(全喉或部分喉切除)第二个癌病人可能不会接受,因此用放疗作为替代。 作者报道麻萨诸塞州总医院用再照射处理20例的经验。其中6例曾报道。男性17例,女性3例,年龄35～81岁,中数62.5岁,随访期1～22年,中数4年。14例为T_(1 2)声门癌,4例声门上癌,1例声门下癌,1例伴随癌——即一个癌在声门上,另一个在咽后壁。用~(60)Co或4MV光子照射,1次/日或2次/日,总量65～66Gy,
After radiotherapy for early laryngeal cancer, a second cancer occasionally occurs in the previously irradiated larynx in long-term survivors. The treatment of this lesion is traditionally not irradiated and it is not possible to achieve full radiotherapy beyond the tolerance of normal laryngeal structures. However, the second cancer patient undergoing surgical treatment (total or partial laryngectomy) may not be accepted and therefore use radiotherapy instead. The authors report the experience of 20 patients treated with re-irradiation at the Massachusetts General Hospital. Six cases were reported. There were 17 males and 3 females, aged 35-81 years, with a median of 62.5 years. The follow-up period ranged from 1 to 22 years and the median was 4 years. 14 cases had T 1 (12) glottic cancer, 4 had supraglottic carcinoma, 1 had supraglottic carcinoma, and 1 had associated cancers - one with the cancer on the glottis and the other behind the pharyngeal wall. With ~ (60) Co or 4 MV photon irradiation, once / day or 2 times / day, the total amount of 65 ~ 66Gy,