Glottik Larenks Kanserlerinde Tedavi Sonuçlarımız Ve Komplikasyonları

AMAÇ: Glottik larenks kanserli hastalardaki tedavi sonuçları ve tedaviye bağlı komplikasyonlar değerlendirildi. Şişli Etfal Eğitim ve Araştırma Hastanesi Radyasyon Onkolojisi Kliniği’ne 1990-2000 yılları arasında glottik larenks kanseri tanısı ile başvuran 84 hasta (82 erkek [%97.6], 2 kadın [%2.4]; ort. yaş 57; dağılım 31-81; erkek-kadın oranı 41/1) geriye dönük olarak incelendi. Altı aydan fazla takip edilen hastalar çalışmaya dahil edildi. Hastaların %89.3’ü sigara kullanıyorken %10.7’si sigara kullanmıyordu. Hastaların tümünün histopatolojisi epidermoid karsinomdu. Tümörün diferansiasyon dereceleri: %44’ü bilinmiyor, %10.7’si iyi, %29.8’i orta, %15.5’i kötü differansiye idi. Evre I’de 23 hasta (%27.4), evre II’de 16 hasta (%19), evre III’de 19 hasta (%22.6), evre IV’de 26 hasta (%31) bulunmaktaydı. Altı hastaya yalnız cerrahi, 19 hastaya radyoterapi (RT), 53 hastaya cerrahi + RT, 4 hastaya cerrahi + RT + kemoterapi (KT), 2 hastaya RT + KT uygulandı. Ortalama takip süresi 54.3 aydı (6-142 ay). RT’ye bağlı komplikasyonlar olarak, %81 ağız kuruluğu, %25.9 mukozit, %22.6 boğazda takılma hissi, %72.6 disfoni, %19 disfaji, %29.7 larenks ödemi, %1.2 tat duyusu kaybı görüldü. Evre I’de 5 yıllık sağkalım %81.3, evre II’de %76.5, evre III’de %21.7, evre IV’de %26.7 olarak saptandı. En sık RT komplikasyonu ağız kuruluğu olup komplikasyonlar en sık RT’nin 2-3. haftasından itibaren gelişmiştir.


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Our Treatment Results And Complıcatıons In Glottıc Laryngeal Cancer

OBJECTIVE: We aimed to assess the results and the complications of the treatments in 84 patients with laryngeal glottic cancer treated at Şişli Etfal Training and Research Hospital. Eighty-four patients (82 males [97.6%], 2 females [2.4%]; mean age 57; range 31 to 81 years; males-females ratio, 41/1) presented with laryngeal glottic cancer diagnosis in Radiation Oncology Clinic of Şişli Etfal Training and Research Hospital between 1990-2000 were evaluated retrospectively. Patients followed-up more than 6 months were included into the study. Eighty-nine point three percent of the patients were smokers and 10.7% of the patients were nonsmokers. All the patients were histologically epidermoid carcinoma. The degree of tumor differentiation was unknown in 44%, well differentiated in 10.7%, moderately well differentiated in 29.8%, poorly differentiated in 15.5%. Twenty-three of the cases (27.4%) were stage I, 16 patients (19%) were stage II, 19 patients (22.6%) were stage III, 26 patients (31%) were stage IV. The treatment methods were only surgery in 6 patients; radiotherapy (RT) in 19 patients; surgery and RT in 53 patients; surgery, RT and chemotherapy (CT) in 4 patients; RT and CT in 2 patients. The mean follow-up was 54.3 months (range, 6-142 month). The complication of RT were: 81% mouth dryness, 25.9% mucositis, 22.6% sensation of a lump in the throat, 72.6% dysphonia, 19% dysphasia, 29.7% edema of the larynx, 1.2% loss of taste. The 5 year survival rates were 81.3% for patients in stage I, 76.5% for stage II, 21.7% in stage III, 26.7% for stage IV. RT’s most common complication was mouth dryness (xerostomia) and onset of this complication occurred beginning from the second or third week of radiotherapy.


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