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作者们报道从1952年至1975年间所经治的348例喉癌,其中除13例发生在喉咽部及2例发生在上段气管外,均为喉部原发性肿瘤,他们均行放疗,三年治愈率为52%。348例患者中曾有52例确诊为喉软骨膜炎或软骨坏死,其发生率为15%。从开始放疗到确诊的时间为3个月至5年。发生软骨膜炎的所有患者均为鳞状细胞癌。软骨膜炎的诊断标准如下:(1)需行气管切开术或应用大剂量抗生素和激素治疗的喉水肿;(2)持续疼痛、失音和喉部压痛;(3)喉部溃疡、口臭、软骨暴露;(4)发生喉皮肤瘘。52例软骨膜炎患者中26例(50%)以后确诊有残余癌存在,预后极差。下列因素易致软骨膜炎:(1)放疗总剂量6,400拉德以下者软骨膜炎发病率在14%以下;超过6,500拉德者,发病率高达30%。(2)放疗的类型。(3)放疗的方
The authors reported on 348 cases of laryngeal cancer that were treated between 1952 and 1975. Among them, 13 cases occurred in the throat and 2 cases occurred in the upper trachea. They were all primary laryngeal tumors. They were all treated with radiotherapy. The three-year cure rate is 52%. Of the 348 patients, 52 had been diagnosed with laryngitis or cartilage necrosis, and the incidence was 15%. The time from the start of radiotherapy to the diagnosis is 3 months to 5 years. All patients with perichonditis are squamous cell carcinomas. The diagnostic criteria for perichonditis are as follows: (1) laryngeal edema requiring tracheotomy or high-dose antibiotics and hormone therapy; (2) persistent pain, aphonia, and tenderness in the throat; (3) throat ulcers, bad breath, Cartilage exposure; (4) Throat skin spasms occur. Of the 52 patients with perichonditis, 26 (50%) were diagnosed with residual cancer and the prognosis was very poor. The following factors are apt to cause perichonditis: (1) The incidence of perichonditis below the total radiation dose of 6,400 rads is below 14%; for patients over 6,500 rads, the incidence is as high as 30%. (2) The type of radiotherapy. (3) Radiation therapy