放射線・化学療法時に気管切開を必要とした 喉頭癌・下咽頭癌症例の検討 転帰と気管孔閉鎖の規定因子の検討

西川 仁, 石田 英一, 日高 浩史

doi:10.2468/jbes.63.15

We studied the outcome of laryngeal and hypopharyngeal cancers requiring tracheotomy for radiotherapy and chemoradiotherapy, focusing on the rate of larynx preservation, the closure rate of the tracheal stoma, and clinical factors relating to successful closure of the tracheal stoma after treatment.<br>The subjects were 13 cases, consisting of 4 cases of laryngeal cancer and 9 cases of hypopharyngeal cancer. They required tracheotomy for radical chemoradiotherapy or radiotherapy between 2003 and 2008 at Iwaki Kyoritsu General Hospital.<br>The overall survival rate was 38% (5/13), and only 11% (1/9) for hypopharyngeal cancer. Although the rate of larynx preservation was 69% (9/13), the closure rate of the tracheal stoma was 23% (3/13) for all 13 cases, and 40% (2/5) for the five final surviving patients. The cause of failure to close the tracheal stoma was mainly death by original cancer, and stenosis of the upper airway by prolonged laryngeal edema in the survival cases. Regarding pre-operative factors affecting stoma closure, there was a correlation between T2 cases and no vocal cord paralysis cases, although no significant difference was observed.<br>The outcome of laryngeal or hypopharyngeal cancer requiring tracheotomy for radiotherapy and chemoradiotherapy was poor, and the possibility of closing a tracheal stoma was low even when the patient received local disease control and survived. To maintain a good relationship after treatment with patients and their families who hope for larynx preservation and choose radiotherapy, it is important to explain the circumstances relating to outcome and closure of tracheal stoma before they receive treatment.

放射線・化学療法時に気管切開を必要とした喉頭癌・下咽頭癌症例の検討転帰と気管孔閉鎖の規定因子の検討

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