• 대한후두음성언어의학회지
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• 제19권1호
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• pp.7-10
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• 2008

The early glottic cancers are traditionally treated by radiotherapy or endoscopic surgery. The excellent effectiveness of both treatment modalities for local control, larynx preservation, and disease specific death is similar. Therefore, functional voice outcome after treatment is one of the most important factors in the choice of treatment for early glottic cancer. To assess the functional outcomes and compare the voice quality in patients with early glottic cancer treated with curative intent with radiotherapy or laser cordectomy, we performed literature review. Most studies showed that the voice quality after radiation therapy is slightly better than that after laser cordectomy. Subanalysis according to types of laser cordectomy, however, indicates that voice quality depends on type of laser cordectomy. Especially, type I or type II laser cordectomy might be superior to other types of laser cordectomy and radiation therapy. We conclude that the laser cordectomy is a good surgical alternative for properly selected early glottic cancer including professional voice users.

• 대한두경부종양학회지
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• 제29권2호
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• pp.58-61
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• 2013

Early glottic cancer can be effectively treated with surgery or radiotherapy showing the comparable treatment results. Since radiation therapy may be better in terms of voice preservation, it tends to be preferred in early glottic cancer. Most common recurrence site is glottis after radiation therapy and complete remission of glottic primary site followed by local recurrence limited to neck is very rare. The authors are reporting a patient with regional recurrence of central neck lymph nodes after radiation therapy for T1a glottic cancer.

• 대한두경부종양학회지
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• 제12권2호
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• pp.201-205
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• 1996

이상의 성적에서 레이저 성대 절제술은 초기 성문암종에 대한 일차 치료법으로 유용하다고 생각되었으며, 일차 절제가 가장 중요하고 그후 성대를 포함한 전체 후두점막에 대하여 주기적으로 현수후두경하에 수술현미경을 이용한 추적관찰과 원격전이 및 이차암의 발생 유무에 대하여 적극적인 추적검사가 필요할 것으로 사료된다.

• Radiation Oncology Journal
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• 제38권1호
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• pp.11-17
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• 2020

Purpose: Definitive radiotherapy remains a primary treatment option for early stage glottic cancer. Intensity-modulated radiation therapy (IMRT) has emerged as the standard treatment technique for advanced head and neck cancers, whereas three-dimensional conformal radiotherapy (3D-CRT) has remained standard for early glottic cancers. We used the National Cancer Database (NCDB) to identify predictors of IMRT use and effect on outcome in these patients. Materials and Methods: We queried the NCDB from 2004-2015 for squamous cell carcinoma of the glottic larynx staged Tis-T2N0 treated with radiation alone. Logistic regression was used to identify predictors of IMRT. Cox regression was used to identify factors predictive of overall survival. Propensity matching was conducted to account for indication bias. Results: We identified 15,627 patients, of which 11% received IMRT. IMRT use rose from 2% in 2004 to 16% in 2015. Predictors of IMRT include: increased comorbidity, T2 stage, urban location, chemotherapy, treatment at an academic center, and later treatment year. Predictors of improved survival were female gender, higher income, lower stage, no chemotherapy, academic facility, and more remote year. There was no difference in survival between 3D-CRT and IMRT across all stages. Conclusions: The rate of IMRT use for early stage glottic laryngeal cancer has increased over time. There was no difference in outcome in patients receiving IMRT versus 3D-CRT across the cohort.

• 대한기관식도과학회지
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• 제16권1호
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• pp.20-26
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• 2010

Transoral $CO_2$ Laser Microsurgery of glottic Carcinoma is replacing external approaches. The qualify of life after surgery for laryngeal cancer may be as important as complete resection of the tumor for patient. Transoral $CO_2$ laser cordectomy for the management of early laryngeal cancer has advantages with regard to oncological results, preservation of laryngeal functions, morbidity and cost in comparison to those of open surgery or radiation therapy. Moreover, transoral laser surgery can be a useful choice as a salvage surgery in radiation therapy failed early glottic cancer. A classification of laryngeal endoscopic cordectomies which included eight different types was described by the European laryngological Society in 2000. We will also introduce type VI which was newly proposed recently.

• 대한후두음성언어의학회지
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• 제7권1호
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• pp.32-38
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• 1996

The preservation of the voice-producing mechanism is an important feature in the management of laryngeal cancer by radiotherapy. But, radiation therapy has certain side effects such as mucositis, tissue edema, necrosis and fibrosis which could effect on normal voice production. Several subjective studies that used questionnaires and auditory perceptual judgements of voice have been interpreted to mean that radiation results in a normal or near-normal voice. Objective evidence of the status of vocal function after radiation treatment, however, is still lacking. We analyzed the changes that occur in voice parameters in a group of patients undergoing radiation therapy, in order to determine the effect of radiation on voice quality. In this study acoustic, aerodynamic measures of vocal function were used to determine the characteristics of voice production. We found that voice parameters in early glottic cancer changed meaningfully comparing to normal larynx with or without radiation and radiation therapy has an little effect on normal larynx.

• 대한후두음성언어의학회지
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• 제13권2호
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• pp.139-144
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• 2002

Background and objectives : The various voice-conserving treatments are used for Tla staged glottic cancer. Especially, Tla staged glottic cancer has been shown excellent treatment result after laser cordectomy or radiotherapy. To evaluate which treatment results better voice after treatment made it valuable to define the exact indication and recommending treatment modality on the Tla staged glottic cancer patients. Method : The medical records of 75 patients with glottic TlaN0 cancer diagnosed at Asan medical center, University of Ulsan college of medicine form May, 1989 to July,2001 were retrospectively reviewed on the point of voice quality and oncology including 5-year survival rate and local control rate. Results : Laser cordectomy and radiotherapy showed 100% and 94.0% 5-year survival rate, respectively. And laser cordectomy had 94.3% local control rate while radiotherapy got 87.6% local control rate. Voice analysis of pretreatment and posttreatment were used to compare each result. Fundamental frequency(F0), shimmer, jitter, noise to harmony ratio(NHR), maximum confortable phonation time(MPT) and vocal efficiency(VE) were used for parameters for voice analysis. Only in shimmer and MPT, we could find significant posttreatment difference between two therapies. In addition, we reviewed the total expenses for each therapy. Conclusion : On the basis of the oncologic result, both the laser cordectomy and radiotherapy had the similar results. Laser cordectomy showed the relatively acceptable voice as radiotherapy did. Laser cordectomy cost less than radiotherapy did. Laser cordectomy can be used for treatment about Tla staged glottic cancer.

• 대한기관식도과학회지
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• 제4권1호
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• pp.91-95
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• 1998

Background： Laryngeal cancer, the most common malignancy of head and neck, is being detected and treated in earlier and more effectively due to introduction of endoscope, continuous development of radiographic technology, and advancement in new surgical techniques such as laser surgery and conservation laryngeal surgery Objectives To compare the different treatment results for early laryngeal cancer to determine which methos provides the good prognosis. Materials and Methods： Retrospective study was done for 135 patients with early laryngeal squamous cell carcinoma(Stage I or II) who were treated at our institute between 1989 to 1996. There were 105 patients with glottic cancer(Stage I: 68 patients, Stage II：37 Patients) and 30 patients with supraglottic cancer(Stage I: 12 patients, Stage II：18 patients) Initial treatment included radiation therapy for 54 patients, endoscopic laser surgery for 8 patients, laryngofissure and cordectomy for 8 patients, vertical partial laryngectomy for 37 patients, supraglottic laryngecomy for 14 patients and supracricoid laryngectomy for 5 patiens, and total laryngectomy for 9 patients. Results : Salvage treatments, such as total laryngectomy, conservation laryngeal surgery, radiation therapy and neck dissection were performed for initial treatment failure with 9 patients after radiation therapy, 8 patients after conservation laryngeal surgery, 2 patients after endoscopic laser and 3 patients after total laryngectomy. Overall 3-year survival rate for glottic 71 was 92.4%, glottic f 84.3%, supraglottic 7172.7%, and supraglottic f was 63.%%. However, survival rate of the same stage was variable according to the choice of initial treatment. Conclusion New classification of the early laryngeal cancer was necessary and helpful for the choice of the initial treatment.

• 대한두경부종양학회지
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• 제21권2호
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• pp.132-138
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• 2005

Purpose: The purpose of this study was to establish general guidelines for the treatment of patients with early glottic cancer(T1-2N0M0), by assessing the role of primary radiation therapy and by analyzing the tumor-related and treatment-related factors that influence treatment results. We also studied the results of hypofractionated radiation therapy for early glottic cancer. Material and Methods: This retrospective study comprised 48 patients who suffered from early glottic cancer and were treated by primary radiotherapy at Inha University Hospital, between May 1997 and October 2004. T-stage distribution showed 38 patients as T1 and 10 patients as stage T2. Thirty-eight patients underwent hypofractionated radiotherapy using a 6 MY photon beam, a total tumor dose of 63Gy, in 5 weekly fractions of 2.25Gy, with an overall radiation treatment time of 38 days. Ten patients in the T2 stage tolerated a total dose of 63-72 Gy(median 68.4Gy) in 5 weekly fractions of 1.8-2.0Gy, with an overall radiation treatment time of 40-87 days(median 51 days). All patients were followed up for at least 3 years. Univariate and multivariate analyses were performed to identify the prognostic factors affecting the treatment results. Result: The 5-year survival rate was 92% for all patients, 94% for T1 patients and 91% for T2 patients. The local control rate was 93.5% for all patients, 95% for T1 and 92.2% for T2 patients. Three patients suffered a relapse following radiotherapy, and underwent subsequent salvage surgery. We included T-stage, tumor location, total radiation dose, field size and overall radiation treatment time as potential prognostic factors. Only T-stage was found to be statistically significant in the univariate analysis, but in the multivariate analysis, it was not found to be significant. Conclusion: High curative and voice preservation rates were obtained with hypofractionated radiotherapy. Further study with a larger number of patients is needed to determine the prognostic factors affecting treatment results.

• Radiation Oncology Journal
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• 제15권4호
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• pp.315-319
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• 1997

목적 : 조기성문암의 치료시 근치적방사선치료의 효율성과 치료실패시 구제술 시행의 효과를 알아보고자 하였다. 대상 및 방법 : 1989년 6월부터 1994년 12월 사이에 경상대학교병원에서 방사선치료를 시행 받은 18명의 T1N0M0과 5명의 T2N0M0을 포함하는 23명의 조기성문암 환자에 대하여 후향적분석을 시행하였다. 모든 환자가 남자이었고, 연령분포는 33세부터 70세로 중앙값은 57세이었다. 추적조사기간의 중앙값은 46개월이었고, $100\%$의 환자에서 추적이 가능하였다. 결과 : 전체환자의 5년 생존율은 $84.3\%$이었고, 병기에 따라서 T1 $94.4\%,\;T2\;53.3\%$이었다. 전체환자의 5년 국소치유율은 $67.8\%$이었고, 병기에 따라서 T1 $70.0\%,\;T2\;60.0\%$이었다. 치료실패한 환자 8명 중 5명에서 구제술이 시행되었다. 구제술후 5년 국소치유율은 T1 $85.6\%,\;T2\;80.0\%$이었다. 결론 : 병기 T1, T2의 조기성문암의 치료시 우선 근치적 방사선치료를 시행하고, 치료실패시구제술을 시행하는 것이 높은 국소치유율과 성대보존율을 기대할 수 있는 효과적인 치료방법이라고 판단된다.