摘要
目的 对解放军总医院经放疗的195例声门型喉癌（glottic cancinoma,GC）患者进行近期生存分析.方法 2007年7月-2013年4月解放军总医院收治195例经放疗的声门型喉癌患者,其中30例接受根治性放疗,165例行术后辅助放疗.放疗采取三维适形放疗（three dimensional conformal radiotherapy,3D-CRT）和调强放疗（intensity modified radiotherapy,IMRT）技术,根治性放疗处方剂量：64.5～70 Gy/33 ～ 35 F,高危计划靶区50 ～ 60 Gy/30 ～ 33 F,低危计划靶区44 ～ 54 Gy/22～ 33 F.结果 中位随访时间36.7个月,全组病例3年无局部复发生存率（local relapse-free survival,LRFS）、无区域复发生存率（regionalrelapse-free survival,RRFS）、无远处转移生存率（metastasis-free survival,MFS）及总生存率（overall survival,OS）分别为91.3％、96.8％、94.2％、90.6％;5年累积生存率分别为88.2％、96.8％、91.7％和83.5％.T分期及临床分期影响患者3年LRFS、MFS及OS,而有无淋巴结转移则影响患者3年RRFS及MFS.多次手术与仅行1次手术患者相比,3年MFS明显降低（x^2=8.810,P=O.003）;Cox回归证实手术次数和是否有淋巴结转移是影响患者3年MFS的独立因素;而影响患者3年OS的独立预后因素包括年龄及T分期.结论 声门型喉癌整体预后较好,放疗在其综合治疗中意义重大,影响GC 3年OS的主要因素为年龄和T分期,手术次数及淋巴结转移则影响3年MFS,手术是放疗失败后GC的有效挽救方式.
Objective To evaluate the preliminary clinical results of 195 glottis cancer （GC） patients treated by three dimensional conformal radiotherapy （3D-CRT） or intensity modified radiotherapy （IMRT）. Methods From July 2007 to April 2013 in Chinese PLA general hospital, 195 newly diagnosed GC patients were treated with radiotherapy, including 30 cases for radical treatment and 165 cases for adjuvant irradiation. The prescription dose was 64.5-70 Gy/33-35 F to the radical target, 50-60 Gy/30-33 F to the high risk target, and 44-54 Gy/22-33 F to the low risk target. Results The median follow up time was 36.7 months （range, 6 to 77 months）. The local relapse-free survival （LRFS）, regional relapse-free survival （RRFS）, distant metastasis-free survival （MFS） and overall survival （OS） were 91.3%, 96.8%, 94.2% and 90.6% for 3 years, 88.2%, 96.8%, 91.7% and 83.5% for 5 years, respectively. The T stage and clinical stage could affect the 3-year LRFS, MFS and OS of patients. There was significant difference in 3-year RRFS and MFS between the patients at stage cN＋ and cN-. Three year MFS in patients for one time resection were lower than those for more than once （X^2=8.810, P=0.003）. Multivariate analysis showed that times of resection and cN ＋ influenced the 3-year MFS （P=0.02） and age and T stage influenced the 3-year OS （P 〈 0.05）. Conclusion The GC patients have good prognosis on the whole. Radiotherapy plays a very important role in comprehensive treatment for GC patients. Age and T stage can influence the 3-year OS and times of resection and cN ＋ can influence the 3-year MFS. Salvage treatment is effective for the failure cases.
出处
《解放军医学院学报》
CAS
2014年第12期1209-1213,共5页
Academic Journal of Chinese PLA Medical School
关键词
声门型喉癌
放疗
生存率
glottic cancinoma
radiotherapy
survival rate
