Analysis Of Partial Laryngectomy For Recurrent Cancer Radiotherapy Treatment Of Meta

BACKGROUND:Laryngeal cancer is one of the common malignant tumor of the Department of Otolaryngology Head and Neck Surgery, ranking second in all primary malignant tumors of epithelial origin in the head and neck. Accounting for1%-5%of the systemic cancer. Radiation therapy of laryngeal cancer control rate is relatively high, but there are recurrence.Residual or recurrent laryngeal cancer is a difficult clinical problem. Although several treatment options exist for patients with laryngeal cancer at first presentation, options for those with recurrent cancer will be limited based on the initial treatment received.With the rapid development of head and neck cancer surgery, laryngeal cancer research continues to deepen the understanding of the treatment of tumors, traditional total laryngectomy is already of a variety of new laryngeal function sparing surgery. Compared with total laryngectomy, partial laryngectomy in the case of removal of the cancer lesions, as much as possible to preserve the integrity of the throat, improve the patient’s quality of life.The role of open conservation （partial） laryngeal surgery in radiorecurrent laryngeal cancers is unclear, and the procedure is not widely accepted or.practiced.Objective:The objective of this review was to assess the oncologic and functional outcomes of partial laryngectomy in radiorecurrent tumors of the larynx reported in the literature.METHODS:The systematic review was performed using independently developed search strategies and included PubMed, Springerlink, WanFang Database, Cnki, and, when appropriate, a manual search. Inclusion criteria for the articles were setapriori. All included articles were subjected to quality assessment. Pooled estimates of local control at24months and of disease-free and overall survival rates were calculated using both a fixed-effects model （inverse square） and a random-effects model （DerSimonian-Laird）.RESULTS:The search identified401publications, of which26studies satisfied all inclusion criteria.18studies had a quality score₆（good）, and21had a score of4or5（fair）. The pooled estimates of oncologic outcomes using the random-effects model were as follows:The local control rate at24months for790patients was86.6%（95%CI,82.2%-90.3%）, the disease-free survival rate for487patients was89.4%（84.4%-93.5%）, and the overall survival rate for538patients was82.1%（85%CI,77.6%-86.1%）. Decannulation of tracheostomy occurred in95.1%（95%CI,92.6%-97.2%） of the patients who were analyzed （n=315）, whereas the pooled mean larynx preservation rate was83.9%（95%CI,80.7%-87%; n=502）.CONCLUSIONS:The current results indicate that open partial laryngectomies for the T1T2recurrence of cancer radiotherapy are more effective, with high control rate, disease-free survival and larynx preservation rate. And vertical partial laryngectomy and Supracricoid partial laryngectomy appear to be more effective.