Treatment of laryngeal cancer

Western medicine mainly treats laryngeal cancer with surgery and radiotherapy, and occasionally with chemotherapy. In principle, early-stage laryngeal cancer is often treated with radiotherapy, which is as effective as surgery and can retain relatively satisfactory language function: mid-stage laryngeal cancer is treated with radiotherapy plus surgery; late-stage cancer is treated with chemotherapy plus radiotherapy. Surgery is the main treatment for cervical lymph node metastasis. In late-stage cancer, the efficacy is poor due to multiple metastases. Laryngeal cancer may be accompanied by laryngeal edema during radiotherapy, as well as laryngeal bleeding and aspiration pneumonia.

The principle of surgical treatment of laryngeal cancer is to reconstruct and restore the three major functions of the larynx, namely, pronunciation, breathing and swallowing, as much as possible, under the premise of completely removing the tumor, so as to achieve the goal of curing the cancer and improving the patient's quality of life after surgery. Therefore, except for larger or more advanced tumors, various laryngeal resections should be used to remove the tumor as much as possible, and neck lymph node dissection should be performed at the same time for patients with cervical lymph node metastasis; selective neck dissection or zonal neck lymph node dissection should also be performed for supraglottic laryngeal cancer with no lymph node enlargement.

According to the location and stage, the specific treatment principles can be summarized as follows:

1. Supraglottic type: Radiotherapy is recommended for stage I, and preoperative radiotherapy and partial laryngectomy or total laryngectomy can be performed for stages II and III.

2. Glottic area type: Radiotherapy is recommended for stage I, and preoperative radiotherapy plus partial laryngectomy or total laryngectomy can be performed for stages II and III.

3. Subglottic type: generally undergo total laryngectomy.

4. Patients with cervical lymph node metastasis must undergo neck dissection.

5. Adenocarcinoma is mainly treated with surgery because it is not very sensitive to radiotherapy and chemotherapy.