累及前联合的早期声门型喉癌治疗： 现在与未来
Treatment of Early Glottic Laryngeal Cancer Involving the Anterior Commissure: Now and Future
摘要: 喉癌是全球常见的头颈部肿瘤，声门型喉癌是最常见的喉癌类型。累及前联合的肿瘤因解剖结构特殊，局部复发率较高，为治疗提出了挑战。针对累及前联合的早期声门型喉癌的最佳治疗方法仍存在争议。本文系统评述了累及前联合的早期声门型喉癌的现有主流治疗方式——经口激光显微手术(TLM)与放射治疗(RT)的肿瘤学结局及功能预后。现有有限证据提示，放射治疗在局部控制率及嗓音质量保留方面可能较手术更具优势。但缺乏大样本、前瞻性随机对照研究的更强证据指导临床治疗决策。此外，本文探讨了新兴手术和放射治疗技术的临床应用进展及未来潜力。
Abstract: Laryngeal cancer is a common head and neck malignancy worldwide, with glottic laryngeal cancer representing the most prevalent subtype. Tumors involving the anterior commissure pose a clinical challenge due to their unique anatomical location, which is associated with higher local recurrence rates. Despite ongoing debates, the optimal treatment for early-stage glottic cancer with anterior commissure involvement remains controversial. This review systematically evaluates the current standard therapeutic approaches—transoral laser microsurgery (TLM) and radiotherapy (RT)—focusing on their oncological outcomes and functional prognosis. Limited evidence suggests that RT may offer advantages over TLM in terms of local control rates and voice quality preservation. However, high-level evidence from large-scale, prospective randomized controlled trials is lacking to guide definitive clinical decision-making. Additionally, this review highlights the clinical advancements and future potential of emerging surgical and radiotherapeutic technologies in managing this complex patient population.
文章引用：樊于止, 魏启春. 累及前联合的早期声门型喉癌治疗： 现在与未来[J]. 临床医学进展, 2026, 16(3): 1468-1477. https://doi.org/10.12677/acm.2026.163928

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