Опухоли головы и шеи. 2016; 6: 17-25
Современные аспекты лечения и реабилитации больных при раке гортани
https://doi.org/10.17650/2222-1468-2016-6-2-17-25Аннотация
Ежегодно в России первичный диагноз рака гортани устанавливают у 6–7 тыс. пациентов. К современным методам диагностики рака гортани относят: прямую и непрямую ларингоскопии, микроларингоскопию, стробоскопию, фиброларингоскопию, рентгеновское исследование, компьютерную томографию, мультиспиральную компьютерную томографию, магнитно-резонансную томографию, ультразвуковое исследование гортани и органов шеи, акустический анализ голоса, морфологические исследования.
В последние годы разработаны новые методы как консервативного, так и хирургического лечения больных раком гортани. В терапии больных со стадиями Т1–2, а у некоторых и при Т3 применяют следующие методики: лучевое, химиолучевое лечение, эндоларингеальную хирургию с использованием лазера, фотодинамическую терапию, открытые функционально-щадящие операции. По данным авторов, на сегодняшний день нет единого алгоритма лечения злокачественных новообразований гортани стадий Т1–3.
При местно-распространенных опухолях гортани и гортаноглотки, соответствующих стадиям T3–4N0–2M0, как правило, выполняют комбинированное лечение с пред- или послеоперационным облучением. Такой подход приводит к нарушению всех функций органа и инвалидизации пациентов. Важнейшей задачей после комбинированного лечения является реабилитация голосовой функции, которая может быть восстановлена с помощью логопедических методик, голосообразующих аппаратов и реконструктивно-пластических операций.
Таким образом, в последние годы разработаны новые подходы к лечению рака гортани – как консервативные, так и хирургические. Однако вопрос о выборе метода лечения и последующей реабилитации пациентов остается дискутабельным.
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Head and Neck Tumors (HNT). 2016; 6: 17-25
Current aspects of treatment and rehabilitation of patients with pharyngeal cancer
https://doi.org/10.17650/2222-1468-2016-6-2-17-25Abstract
Annually in Russia primary diagnosis of new-onset pharyngeal cancer is made in approximately 6–7 thousand people. To modern methods of diagnosing pharyngeal cancer belong: direct and indirect laryngoscopy, microlaryngoscopy, stroboscopy, fibrolaryngoscopy, X-ray study examination, computed tomography, multispiral computed tomography, magnetic resonance tomography, ultrasonographic examination of the throat and organs of the neck, acoustic analysis of voice and morphological studies.
Recent years witnessed the development of novel methods of both conservative and surgical management of patient with pharyngeal cancer. Treatment of patients with stage T1–2 and in some patients with stage T3 includes the following methods: radiotherapy, chemoradiotherapy, endolaryngeal surgery with laser, photodynamic therapy, open functionally sparing operations. According to the data of the authors, today currently there is no common algorithm for treatment of stage T1–3 pharyngeal malignant neoplasms.
Locally disseminated tumors of the throat and laryngopharynx, corresponding to stages T3–4N0–2M0 as a rule are treated by combined management with pre- or postoperative irradiation. Such approach results in leads to impairment of all functions of the organ and invalidity disablement of patients. The most important task after combined treatment is rehabilitation of the voice function, which may be restored by means of logopedic methods, voice-forming devices and reconstructive plastic operations.
Hence novel approaches to treatment of pharyngeal cancer – both conservative and surgical have recently been worked out. However the problem concerning regarding therapeutic decision-making followed by rehabilitation of patients remains disputable.
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