• 대한두경부종양학회지
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• 제9권2호
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• pp.193-199
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• 1993

The prognosis of supraglottic cancer is worse than that of glottic cancer. Supraglottic cancers by subsites have different microenvironment of cancer cells, locoregional spread patterns. Therefore we presume that high therapeutic efficacy, while preserving the organ, can be obtained when supraglottic cancer is treated effectively according to its biological behaviors. For the purpose of determination of clinical characteristics and causes of treatment failures by subsites of supraglottis, the authors analyzed 24 cases(stage III 14 cases, stage IV 10 cases) of supraglottic cancer which were managed mainly by surgery in our institute. The results were as follows; 1) The suprahyoid group had worse pathologic grades, more frequent spread to hypopharynx, more freguent recurrence at primary site, and better three-year survival rate than the infrahyoid group. 2) The infrahyoid group had more frequent spread to glottis, understaging, recurrence at cervical nodes than the suprahyoid group. 3) There was no differences in nodal metastasis by sub sites. These results suggest that the suprahyoid group may have more aggressive spread pattern but better prognosis than the infrahyoid group.

• 대한음성언어의학회:학술대회논문집
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• 대한음성언어의학회 2006년도 제25회 학술대회
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• pp.158-158
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• 2006

• 대한미세수술학회:학술대회논문집
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• 대한미세수술학회 1995년도 제15차 학술대회
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• pp.72.1-72.1
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• 1995

• 대한두경부종양학회지
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• 제15권1호
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• pp.18-21
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• 1999

Background and Objectives: Occult neck metastasis rate of laryngeal and hypopharyngeal cancer varies widely depending upon authors. Materials and Methods: Sixty four cases, previously untreated, of N0 laryngeal and hypopharyngeal squamous cell carcinoma patients who underwent surgery as an initial treatment from 1992 to 1997 were evaluated. All had unilateral or bilateral elective neck dissection at the time of surgery for the primary. Occult neck metastasis rate was evaluated with pathologic examination of neck dissection specimen. Results: Occult neck metastasis rate by primary site was as follows. Supraglottis ipsilateral 32%(8/25) contralateral 15%(3/20), glottis ipsilateral 17%(5/30), contralateral 0%(0/22), hypopharynx ipsilateral 78%(7/9), contralateral 25%(2/8). Conclusion: Supraglottic and hypopharyngeal cancer may need elective neck treatment bilaterally. Occult neck metastasis of glottic cancer to opposite site was minimal.

• Radiation Oncology Journal
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• 제37권2호
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• pp.82-90
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• 2019

Purpose: To evaluate the results of hypofractionated radiotherapy (HFX) for early glottic cancer. Materials and Methods: Eighty-five patients with cT1-2N0M0 squamous cell carcinoma of the glottis who had undergone HFX, performed using intensity-modulated radiotherapy (IMRT, n = 66) and three-dimensional conformal radiotherapy (3D CRT, n = 19) were analyzed. For all patients, radiotherapy was administered at 60.75 Gy in 27 fractions. Forty-three patients received a simultaneous integrated boost (SIB) of 2.3-2.5 Gy per tumor fraction. Results: The median follow-up duration was 29.9 months (range, 5.5 to 76.5 months). All patients achieved complete remission at a median of 50 days after the end of radiotherapy (range, 14 to 206 days). The 5-year rates for locoregional recurrence-free survival was 88.1%, and the 5-year overall survival rate was 86.2%. T2 stage was a prognostic factor for locoregional recurrence-free survival after radiotherapy (p = 0.002). SIB for the tumor did not affect disease control and survival (p = 0.191 and p = 0.387, respectively). No patients experienced acute or chronic toxicities of ≥grade 3. IMRT significantly decreased the dose administered to the carotid artery as opposed to 3D CRT (V₃₅, p < 0.001; V₅₀, p < 0.001). Conclusions: Patients treated with HFX achieved acceptable locoregional disease control rates and overall survival rates compared with previous HFX studies. A fraction size of 2.25 Gy provided good disease control regardless of SIB administration.

• Radiation Oncology Journal
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• 제29권2호
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• pp.115-120
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• 2011

목 적: 조기 성문암 환자에서 방사선치료의 만기 합병증인 뇌졸증을 예방하기 위해 경동맥을 보호하는 치료계획을 세우고 타당성을 알아보고자 연구를 계획하였다. 대상 및 방법: 2007년 1월부터 2010년 12월까지 원발성 조기 성문암으로 방사선치료를 받은 환자 중 전산화단층촬영모의 치료를 받은 환자 31명의 모의치료 영상을 대상으로 하였다. 기존의 평행대항조사영역(parallel-opposing field, POF)과 조사영역의 빔방향상에서 동측의 경동맥을 제외하기 위해 빔각도를 조절한 조사영역(modified oblique field, MOF)으로 가상모의치료계획을 세우고 계획용표적체적, 경동맥과 척수의 선량분포, 평균선량과 $V_{35}$, $V_{40}$, $V_{50}$ 등을 기존 치료와 비교 분석하였다. 결 과: 전체 31명 중 23명(74.2%)에서 25도, 8명(25.8%)에서 30도 전방으로 조절되었다. 두 군 사이에 선량에 따른 Planning target volume의 체적백분율은 차이를 보이지 않았다(p=0.801). 경동맥의 선량에 따른 누적 체적백분율은 의미 있는 차이를 보였고(p<0.001), 26 Gy 이후에 MOF군에서 감소하기 시작했다. 경동맥의 평균선량은 POF군에서 38.5 Gy, MOF군에서 26.3 Gy였고(p=0.012), $V_{35}$, $V_{40}$, $V_{50}$ 모두에서 의미 있는 차이를 보였다. 결 론: 이번 연구 결과로 조기 성문암 환자에서 빔각도를 전방으로 조절하여 경동맥의 조사선량을 감소시켰다. 이를 통해 경동맥 협착증을 예방하고 궁극적으로 뇌졸증을 줄일 수 있을 것으로 예상한다.

• 대한기관식도과학회지
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• 제8권1호
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• pp.75-80
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• 2002

Radiation therapy is an effective treatment modality for malignant disease of the head and neck, but it is not without risk and complication. Response of the larynx to radiotherapy varies from mild erythema to severe inflammation with edema and induration. possibly leading to necrosis of cartilage. These changes are due to an inflammatory reaction characterized by infiltration of polymorphonuclear leukocytes, vascular thrombosis, and obliteration of lymphatic channels. Late changes consist of telangiectasia of the skin, alopecia, loss of subcutaneous fat, degenerative changes in the connective tissues. But, radiation necrosis of laryngeal cartilage is an uncommon complication and it is a devastating process for which further necessitates surgical treatment. It is generally agreed that the only treatment for patient not responding to conservative measures is a total laryngectomy. We experienced 4 cases of delayed radionecrosis of the larynx who underwent radiation therapy for glottic cancer and hypopharyngeal cancer. We report these cases with review of literature.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1983년도 제17차 학술대회연제순서 및 초록
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• pp.6.2-6
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• 1983

이비인후과 영역의 종양중 후두종양은 비교적 흔히 볼 수 있으며, 그 특이한 증상과 간접후두경 및 후두직달경 등으로 조기진단이 가능한 반면에 증상의 경과도 빨라 치명율 역시 높은 것이 사실이다. 이에 저자는 1978년 6월부터 1983 년 2월까지 본 병원에 내원하여 애성 및 후두종양을 발견한 108명의 환자를 임상적 및 병리학적으로 분류하여 문헌적 고찰과 함께 보고하는 바이다.

• 대한후두음성언어의학회지
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• 제15권2호
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• pp.128-132
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• 2004

Objectives : The total laryngectomy for laryngeal cancer has made patients be afraid of voice loss. Early staged glottic or supraglottic cancer can be treated with conservative laryngeal surgery which preserve voice, though which was not normal voice comparing before. Voice analysis is used to evaluates objectively the quality of the voice in pre- and postoperation, 4 different types of conservative laryngeal surgery : laser cordectomy, supracticoid partial laryngectomy, vertical partial laryngectomy, and supralottic laryngectomy. Materials and Methods : The patients who received conservative laryngeal surgery(laser cordectomy : 23 cases, vertical partial laryngecotmy : 9cases, supracriocoid partial laryngectomy : 6cases, supraglottic laryngectomy : 8cases) from 1995 to 2001 in the Asan medical center. Fundamental frequency(F0), shimmer, jitter, noise to harmony ratio(NHR), maximum comfortable phonation time and subglottic pressure were used as parameters for voice analysis. Results : The patients who received laser cordectomy(shimmer : 5.26${\pm}$1.12%, jitter : 3.33${\pm}$0.42%, NHR : 0.47${\pm}$0.02, MPT : 9.32${\pm}$3.59sec) and supraglottic laryngectomy(shimmer : 4.39${\pm}$1.03%, jitter : 1.49${\pm}$0.14%, NHR : 0.51${\pm}$0.06, MPT : 8.9${\pm}$0.59sec) showed better results than other two procedures, but differed from normal value. Especially the patients who received supracricoid partial laryngectomy(shimmer : 9.23${\pm}$1.56%, jitter : 5.81${\pm}$1.23%, NHR : 5.89${\pm}$1.13, MPT : 6.3${\pm}$1.18sec, MFR : 632${\pm}$89ml/sec) had poorer quality of voice but presented fast functional recovery time, and the subjective symptom was improved as time goes by slowly. Conclusion : The appropriate conservative laryngeal surgery for each cancers and stage can preserve the acceptable voice for patients. Supracricoid partial laryngectomy for T1b glottic cancer can be used for acceptable voice despite its poor voice analysis.

• 대한두경부종양학회지
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• 제25권1호
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• pp.28-32
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• 2009

Background : The most frequently reported risk factors for head and neck suamous cell carcinoma are smoking and alcohol. But in a recent overview, human papilloma virus(HPV) infection was revealed the important carcinogenic factor in oropharyngeal cancer. We aimed to clarify whether HPV directly effects on the oncogenesis and biologic behavior of hean and neck squamous cell carcinoma by comparison with infection prevalence, and physical status of virus. Material and Method : We used HPV genotyping DNA chip(Biocore, Korea, Seoul) arrayed by multiple oligonucleotide probes of L1 sequence of 26 types of HPV and HPV genotypes are identified by fluorescence scanner. The copy numbers of HPV E2 and E6 open reading frames(ORF) were assessed using a TaqMan-based 5'-exonuclease quantitative real-time PCR assay. The ratio of E2 to E6 copy numbers was calculated to determine the physical status of HPV-16 viral gene. Results : We observed a significant difference in HPV prevalence between tonsillar cancer group and control group(73.1% vs. 11.6%), and most of the HPVs were type 16(87.2%) and integrated(94.1%) state. In terms of oral tongue cancer, we demonstrate that 30.5% has integrated HPV-16 in cancer tissue. But Glottic cancer only 1% is related to HPV-16 integration. Conclusion : This study revealed significant relationship of HPV prevalence with oropharyngeal and oral tongue squamous cell carcinoma. Most of HPV were 16 type and integrated or mixed, HPV-16 integration could be directly related to the carcinogenesis.