患者在患一种头颈肿瘤后患其他头颈肿瘤的风险明显升高,特别是继续吸烟的患者。 目前并没有有效的喉癌预防措施,但是很多研究探究了后续上呼吸消化道恶性肿瘤及戒烟后喉癌复发的预防措施。
维生素E衍生物、维生素A以及干扰素联合治疗方案可能有效地预防晚期患者肿瘤复发及发生第二原发性上呼吸消化道肿瘤。[81]Seixas-Silva JA Jr, Richards T, Khuri FR, et al. Phase 2 bioadjuvant study of interferon alfa-2a, isotretinoin, and vitamin E in locally advanced squamous cell carcinoma of the head and neck: long-term follow-up. Arch Otolaryngol Head Neck Surg. 2005;131:304-307.http://archotol.ama-assn.org/cgi/content/full/131/4/304http://www.ncbi.nlm.nih.gov/pubmed/15837897?tool=bestpractice.com 尚需进一步随机对照研究。 临床试验表明大剂量维生素A衍生物作用类似抗肿瘤药物。[82]Sporn MB, Dunlop NM, Newton DL, et al. Prevention of chemical carcinogenesis by vitamin A and its synthetic analogs (retinoids). Fed Proc. 1976;35:1332-1338.http://www.ncbi.nlm.nih.gov/pubmed/770206?tool=bestpractice.com 一项实验研究发现低剂量异维甲酸并不能降低第二原发肿瘤、死亡及吸烟相关疾病的风险。[83]Khuri FR, Lee JJ, Lippman SM, et al. Randomized phase III trial of low-dose isotretinoin for prevention of second primary tumors in stage I and II head and neck cancer patients. J Natl Cancer Inst. 2006;98:441-450.http://jnci.oxfordjournals.org/cgi/content/full/98/7/441http://www.ncbi.nlm.nih.gov/pubmed/16595780?tool=bestpractice.com 绿茶提取物和COX-2抑制剂可以在离体及动物模型上减慢肿瘤进展。[66]Zhang X, Zhang H, Tighiouart M, et al. Synergistic inhibition of head and neck tumor growth by green tea (-)-epigallocatechin-3-gallate and EGFR tyrosine kinase inhibitor. Int J Cancer. 2008 Sep 1;123(5):1005-14.http://www.ncbi.nlm.nih.gov/pubmed/18546267?tool=bestpractice.com[84]Zhang X, Chen ZG, Choe MS, et al. Tumor growth inhibition by simultaneously blocking epidermal growth factor receptor and cyclooxygenase-2 in a xenograft model. Clin Cancer Res. 2005;11:6261-6269.http://clincancerres.aacrjournals.org/cgi/content/full/11/17/6261http://www.ncbi.nlm.nih.gov/pubmed/16144930?tool=bestpractice.com