Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2021, Vol. 35 ›› Issue (2): 60-66.doi: 10.6040/j.issn.1673-3770.1.2020.102

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Application of radiofrequency ablation with plasma spot excitation in early glottic carcinoma(Tis-T1b)

XIAO Xuping, ZHOU En, XIAO Yu   

  1. Department of Otorhinolaryngology & Head and Neck Surgery, The First Affiliated Hospital of Hunan Normal University/Hunan Provincial People's Hospital, Changsha 410000, Hunan, China
  • Published:2021-04-20

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Abstract: Objective This study aimed to evaluate the efficacy of radiofrequency coblation(RFC)in the treatment of early glottic carcinoma(Tis-T1b). Methods A total of 58 patients with early glottic carcinoma(Tis-T1b)at People's Hospital were enrolled from October 2018 to April 2020. All patients were men. According to the surgical method, 31 and 27 patients were included in the RFC and CO2 laser groups, respectively. The average patient age was 52.1±8.7 and 55.6±10.3 years in the RFC and CO2 laser groups, respectively. In the RFC group, the tumor-node-metastasis(TNM)stage was Tis, T1a, and T1b in 6, 23, and 2 patients, respectively, while in the CO2 laser surgery group, the TNM stage was Tis, T1a, and T1b in 3, 22, and 2 patients, respectively. All patients were followed up for 6-18 months, and the operation time, postoperative pain score, and cough score were recorded. All patients underwent reassessment at 1, 3, and 6 months after surgery using an electronic laryngoscope. Results The operation time was shorter in the RFC group than in CO2 laser group(11.81 vs. 16.77 min, P<0.001). There were no significant differences in the length of hospital stay, blood loss, pain score, cough score, anterior conglutination rate, and granulomatous hyperplasia between the groups(P=0.676,0.390,0.483,0.483,0.094,0.788). All patients were followed up in the outpatient department. No deaths occurred during the follow-up period. Four patients developed local recurrence, including 2 patients(1 patient with T1b involving anterior commissure and 1 patient with T1a)in the RFC group and 2 patients(2 patients with T1b involving anterior commissure)in the CO2 laser group. Both patients in the RFC group underwent repeat plasma surgery and 1 patient in the CO2 laser group underwent CO2 laser extended resection. In one patient with unilateral cervical lymph node metastasis, the surgery was converted to open surgery. There was no significant difference in the local recurrence rate between the groups(P=0.276). The acoustic parameters of Jitter, Shimer, and NHR recovered gradually in all patients at different time points postoperatively(P<0.05), and the acoustic parameters of the RFC group were better than those of the CO2 laser group(P=0.000,0.001,0.000). Conclusion Radiofrequency ablation with the plasma spot excitation technique is safe and effective for the treatment of early glottic carcinoma(Tis-T1b). It has the advantages of short operation time, small mucosal injury, and good preservation of voice function. However, the long-term tumor control rate and survival rate need to be further observed.

Key words: Radiofrequency ablation, Plasma spot excitation, Glottic carcinoma, Voice function

CLC Number: 

  • R767.91
[1] Takes RP, Strojan P, Silver CE, et al. Current trends in initial management of hypopharyngeal cancer: the declining use of open surgery[J]. Head Neck, 2012, 34(2): 270-281. doi:10.1002/hed.21613.
[2] Ansarin M, Cattaneo A, de Benedetto L, et al. Retrospective analysis of factors influencing oncologic outcome in 590 patients with early-intermediate glottic cancer treated by transoral laser microsurgery[J]. Head Neck, 2017, 39(1): 71-81. doi:10.1002/hed.24534.
[3] 黄冠江, 罗梦思, 张靖萱, 等. T1a声门型喉癌患者激光和放射治疗后嗓音功能评估文献的Meta分析[J]. 听力学及言语疾病杂志, 2017, 25(5): 529-535. doi:10.3969/j.issn.1006-7299.2017.05.021. HUANG Guanjiang, LUO Mengsi, ZHANG Jingxuan, et al. A comparative assessment of voice after laser surgery versus radiotherapy of T1a glottic carcinoma: a meta-analysis[J]. J Audiol Speech Pathol, 2017, 25(5): 529-535. doi:10.3969/j.issn.1006-7299.2017.05.021.
[4] Greulich MT, Parker NP, Lee P, et al. Voice outcomes following radiation versus laser microsurgery for T1 glottic carcinoma: systematic review and meta-analysis[J]. Otolaryngol Head Neck Surg, 2015, 152(5): 811-819. doi:10.1177/0194599815577103.
[5] 周天骄, 易红良. 等离子射频消融技术治疗早期声门型喉癌的研究进展[J]. 临床耳鼻咽喉头颈外科杂志, 2015, 29(6): 577-580. doi:10.13201/j.issn.1001-1781.2015.06.029. ZHOU Tianjiao, YI Hongliang. The progress of radiofrequency ablation technique in the early glottic cancer[J]. J Clin Otorhinolaryngol Head Neck Surg, 2015, 29(6): 577-580. doi:10.13201/j.issn.1001-1781.2015.06.029.
[6] Chun YS, Pawlik TM, Vauthey JN. 8th edition of the ajcc cancer staging manual: pancreas and hepatobiliary cancers[J]. Ann Surg Oncol, 2018, 25(4):845-847. doi: 10.1245/s10434-017-6025-x.
[7] 徐夏, 邓文婷, 黄成志, 等. 喉内镜下等离子消融术与开放性手术治疗早期喉癌的疗效对比[J]. 山东大学耳鼻喉眼学报, 2019, 33(2): 81-85. doi:10.6040/j.issn.1673-3770.0.2018.177. XU Xia, DENG Wenting, HUANG Chengzhi, et al. Curative effect analysis of endoscopic laryngeal surgery with plasma radiofrequency ablation versus open surgery to treat early glottic cancer[J]. J Otolaryngol Ophthalmol Shandong Univ, 2019, 33(2): 81-85. doi:10.6040/j.issn.1673-3770.0.2018.177.
[8] Shuang Y, Li C, Zhou X, et al. Outcomes of radiofrequency ablation(RFA)and CO2 laser for early glottic cancer[J]. Am J Otolaryngol, 2016, 37(4): 311-316. doi:10.1016/j.amjoto.2016.03.002.
[9] Zhang Y, Wang BR, Sun GB, et al. Carbon dioxide laser microsurgery versus low-temperature plasma radiofrequency ablation for T1a glottic cancer: a single-blind randomized clinical trial[J]. Biomed Res Int, 2018, 2018: 4295960. doi:10.1155/2018/4295960.
[10] 杨淑芝, 周成勇, 王丰, 等. 经口低温等离子手术治疗侵犯前连合的早期声门型喉癌[J]. 中华耳鼻咽喉头颈外科杂志, 2018, 53(2): 86-91. doi:10.3760/cma.j.issn.1673-0860.2018.02.002. YANG Shuzhi, ZHOU Chengyong, WANG Feng, et al. Analysis of curative effect of transoral radiofrequency ablation microsurgery on glottic carcinoma with anterior commissure involvement at the early stage[J]. Chin J Otorhinolaryngol Head Neck Surg, 2018, 53(2): 86-91. doi:10.3760/cma.j.issn.1673-0860.2018.02.002.
[11] 刘卫兴, 陈桂, 宋丽娟, 等. 早期声门型喉癌经低温等离子射频消融术和CO2激光治疗的Meta分析[J]. 中华生物医学工程杂志, 2020, 26(1): 15-20. doi:10.3760/cma.j.issn.1674-1927.2020.01.003. LIU Weixing, CHEN Gui, SONG Lijuan, et al. Low-temperature plasma radiofrequency ablation and CO2 laser treatment for early glottic laryngeal cancer: a meta-analysis[J]. Chin J Biomed Eng, 2020, 26(1): 15-20.doi:10.3760/cma.j.issn.1674-1927.2020.01.003.
[12] Canis M, Ihler F, Martin A, et al. Transoral laser microsurgery for T1a glottic cancer: review of 404 cases[J]. Head Neck, 2015, 37(6): 889-895. doi:10.1002/hed.23688.
[13] 谭凤武, 邓亚萍, 黎可华. 低温等离子射频消融与CO2激光手术治疗早期声门型喉癌疗效的Meta分析[J]. 山东大学耳鼻喉眼学报, 2020, 34(6): 63-71. TAN Fengwu, DENG Yaping, LI Kehua. The therapeutic effects of low temperature plasma radiofrequency ablation and CO2 laser surgery on early glottic carcinoma: a Meta-analysis[J]. J Otolaryngol Ophthalmol Shandong Univ, 2020, 34(6): 63-71.
[14] 折素珍, 王斌全, 李莹, 等. CO2激光治疗前连合受累的早期声门型喉癌的预后分析[J]. 临床耳鼻咽喉头颈外科杂志, 2015, 29(24): 2121-2125. doi:10.13201/j.issn.1001-1781.2015.24.005. SHE Suzhen, WANG Binquan, LI Ying, et al. Prognostic analysis of CO2 laser surgery for early glottic cancer with anterior commissure involvement[J]. J Clin Otorhinolaryngol Head Neck Surg, 2015, 29(24): 2121-2125. doi:10.13201/j.issn.1001-1781.2015.24.005.
[15] Campo F, Zocchi J, Ralli M, et al. Laser microsurgery versus radiotherapy versus open partial laryngectomy for T2 laryngeal carcinoma: a systematic review of oncological outcomes[J]. Ear Nose Throat J, 2021, 100(1_suppl): 51S-58S. doi:10.1177/0145561320928198.
[16] 周剑盛. CO2激光治疗早期声门型喉癌疗效的影响因素分析[D]. 杭州: 浙江大学, 2018.
[17] Peretti G, Piazza C, Cocco D, et al. Transoral CO2 laser treatment for Tis-T3 glottic cancer: The University of Brescia experience on 595 patients[J]. Head Neck, 2009, 32(8): 977-983. doi:10.1002/hed.21278.
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