CAJ | 학술논문

目的探讨原发性喉小细胞癌的临床、病理特点及其诊断、治疗方法并分析其预后。方法回顾性分析中山大学肿瘤防治中心1990年1月至2009年8月诊治的6例原发性喉小细胞癌患者的临床资料，结合临床表现和纤维喉镜活检标本的病理检查确诊原发性喉小细胞癌。本组6例患者中1例放弃治疗，1例行单纯化疗，1例行声门上半喉切除术和辅助放化疗，1例行诱导化疗+放疗+辅助化疗，2例行诱导化疗+同步放化疗+辅助化疗。化疗药物包括博来霉素、氟尿嘧啶、顺铂、依托泊苷、紫杉醇，化疗3～6周期。放疗采用60Coγ射线或4MVX射线，常规照射或三维适形放疗，剂量60 ～66 Gy，6～7周。结果 6例患者中，除1例临床分期为Ⅲ期外，其余5例均为ⅣA期。随访3～24个月，中位随访时间13个月。1例放弃治疗者3个月后死于呼吸衰竭；2例行同步放化疗者至今分别无瘤生存8个月和24个月，其余3例患者于8 ～12个月后死于肺或肝转移。结论该病易全身播散，治疗前需行全面评估，化疗在治疗中占有重要地位，同步放化疗是本病的理想治疗模式。
목적 탐토원발성후소세포암적림상、병리특점급기진단、치료방법병분석기예후。방법 회고성분석중산대학종류방치중심1990년1월지2009년8월진치적6례원발성후소세포암환자적림상자료，결합림상표현화섬유후경활검표본적병리검사학진원발성후소세포암。본조6례환자중1례방기치료，1례행단순화료，1례행성문상반후절제술화보조방화료，1례행유도화료+방료+보조화료，2례행유도화료+동보방화료+보조화료。화료약물포괄박래매소、불뇨밀정、순박、의탁박감、자삼순，화료3～6주기。방료채용60Coγ사선혹4MVX사선，상규조사혹삼유괄형방료，제량60 ～66 Gy，6～7주。결과 6례환자중，제1례림상분기위Ⅲ기외，기여5례균위ⅣA기。수방3～24개월，중위수방시간13개월。1례방기치료자3개월후사우호흡쇠갈；2례행동보방화료자지금분별무류생존8개월화24개월，기여3례환자우8 ～12개월후사우폐혹간전이。결론 해병역전신파산，치료전수행전면평고，화료재치료중점유중요지위，동보방화료시본병적이상치료모식。
Objective To study the clinical characteristics, pathological features, diagnosis,therapy and prognosis of primary small cell carcinoma of the larynx (PSCCL). Methods Six cases of PSCCL collected from 1990 to 2009 was retrospectively analyzed. The diagnosis was confirmed by pathological examination. Among six patients, one case belonged to stage Ⅲ, and the others were in stage ⅣA. One case abandoned treatment; one case received chemotherapy; one case underwent supraglottic hemilaryngectomy and adjuvant chemoradiotherapy; one case underwent induction chemotherapy, radiotherapy and consolidation chemotherapy. Two cases received induction chemotherapy, concurrent chemoradiation and consolidation chemotherapy. The drug regimens included bleomycin, fluorouracil,cisplatin, etoposide and taxel for 3 -6 cycles. The radiotherapy technique included conventional radiotherapy, CT-Sim and three dimensional conformal radiation therapy with 60Co or 4 MV X-ray for 60 -66 Gy during 6 - 7 weeks. Results The time of follow-up was 3 - 24 months and the median was 13 months. Two patients applied with concurrent chemoradiation were alive without tumor. The patient abandoning therapy died of respiratory failure, and the others died of lung or liver metastasis after 8 -12 months. Conclusions PSCCL is a disseminated disease, so the pretreatment evaluation is nessesary.Concurrent chemoradiation is an ideal treatment model for this disease.