化免放联合治疗声门型喉癌术后气管食管沟淋巴结转移1例

Immunotherapy Combined with Chemotherapy and Radiotherapy in the Treatment of Postoperative Tracheoesophageal Groove Lymphatic Metastasis of Glottic Carcinoma: A Case Report

摘要:

喉癌发病率呈逐年上升趋势。声门型喉癌是最常见的喉癌类型，早期声门型喉癌颈部淋巴结隐匿性转移的风险约0%~8%。近年来，头颈肿瘤的治疗已全面进入免疫治疗时代，免疫治疗成为转移性头颈肿瘤的一线治疗。本文报道了1例初诊为声门型喉癌（T2N0M0）的患者在右侧声带切除、额侧垂直半喉切除、颈阔肌皮瓣修复喉功能重建术后16个月发现气管食管沟淋巴结转移，行化免放联合治疗后，患者临床症状改善，癌肿较前缩小96.56%。患者规律随访至2024年12月，已获得生存期53个月，影像学检查提示肿瘤保持稳定，未见新发转移灶，病情可控。

Abstract:

The incidence of laryngeal cancer has been increasing annually. Glottic carcinoma represents the most prevalent subtype of this malignancy. The risk of occult metastasis to cervical lymph nodes in early-stage glottic carcinoma is estimated to be between 0% and 8%. In recent years, the management of head and neck cancers has fully transitioned into the era of immunotherapy, with immunotherapy now serving as the first-line treatment for metastatic head and neck cancers. This paper reports a patient with glottic carcinoma (T2N0M0) who found tracheoesophageal groove lymph node metastasis 16 months after surgery (right vocal cord resection, frontal vertical hemilaryngectomy, and platysma flap repair for laryngeal function reconstruction). The patient received a combination of immunotherapy, chemotherapy, and radiotherapy. During the treatment, the patient's symptoms improved, and the tumor size was reduced by 96.56% compared to its previous state. The patient has been regularly followed up until December 2024, achieving a survival duration of 53 months. Imaging examinations suggest that the tumor has remained stable without any new metastatic lesions.