摘要
目的 探讨手术与非手术综合治疗晚期下咽癌患者生存情况、并发症及器官功能保留情况.方法 回顾性分析2010年1月至2014年12月在解放军总医院耳鼻咽喉头颈外科确诊的1 19例晚期下咽癌患者的临床资料,119例患者中男112例（94.1％）,女7例（5.9％）;年龄27 ～ 78岁,中位年龄57岁.119例患者分为2组：手术综合治疗组（42例）与非手术综合治疗组（77例）,收集患者基本临床情况,治疗、随访及生存情况,采用Kaplan-Meier法绘制生存曲线,Log-rank检验比较2组间生存情况.应用x2检验比较2组间并发症及喉器官功能保留率情况.结果 下咽癌手术综合治疗组5年无瘤生存率及总生存率分别为53.9％和54.9％,高于非手术综合治疗组的45.1％和45.6％,但差异无统计学意义（χ2无瘤生存率=1.251,P无瘤生存率=0.263;x2总生存率=1.749,P总生存率=0.186）.2组并发症发生率差异无统计学意义（x2=0.858,P=0.354）.下咽癌非手术综合治疗组与手术综合治疗组喉器官功能保留率分别为71.4％（55/77）、50.0％（21/42）,差异有统计学意义（x2=6.493,P=0.011）.结论 晚期下咽癌恶性程度高,治疗效果相对较差.综合治疗是晚期下咽癌的主要治疗方式.手术综合治疗在无瘤生存率及总生存率上与非手术综合治疗相当,但在器官功能保留率上低于非手术综合治疗.应依据患者不同情况,合理选择治疗方案.
Objective To compare the treatment outcomes for locally advanced hypopharyngeal carcinoma between surgery plus radio （chemo） therapy （SRT） and non-surgery chemoradiotherapy （CRT）.Methods A total of 119 patients diagnosed with advanced hypopharyngeal carcinoma without distant metastases between 2010 and 2014 were identified in the Chinese People＇s Liberation Army General Hospital,and they were divided into 2 groups：42 cases in SRT group and 77 cases in CRT group.Patients＇clinical information was collected.Survival rates and prognostic factors were analyzed by the Kaplan-Meier method with SPSS 23.0 software.The survival rates,laryngeal preservation rates and complication rates were compared between the two groups using the chi-square test.Among the 119 patients,112 were males and 7 were females.Age ranged from 27 to 78 years,with an average age of 57 years.Results There were no significant difference between the SRT and CRT group for five-year disease-free survival （DFS,53.9% vs.45.1%,χ2 =1.251,P =0.263） and overall survival （OS,54.9% vs.45.6%,χ2 =1.749,P =0.186）.Compared to SRT group,CRT group did not showed the significant increase of treatment complications （χ2 =0.858,P =0.354）,with a higher laryngeal preservation rate （50.0% vs.71.4%,χ2 =6.493,P =0.011）.Conclusions Advanced hypopharyngeal carcinoma is of high malignancy and poor prognosis.Combined modality treatment is a main approach for advanced hypopharyngeal cancer.SRT offers diseasefree survival and overall survival rates equivalent to CRT,but with a higher laryngeal preservation rate.
作者
张永侠
彭洪华
张欣欣
赵建东
武文明
王嘉陵
黄德亮
纵亮
陈立伟
刘宸箐
刘明波
Zhang Yongxia;Peng Honghua;Zhang Xinxin;Zhao Jiandong;Wu Wenming;Wang Jialing;Huang Deliang;Zong Liang;Chen Liwei;Liu Chenqing;Liu Mingbo(Department of Otorhinolaryngology Head and Neck Surgery, Chinese People Liberation Army General Hospital, Beijing 100853, China;Department of Otorhinolaryngology, Affiliated Hospital of Weifang Medical University, Weifang 261031, China)
出处
《中华耳鼻咽喉头颈外科杂志》
CAS
CSCD
北大核心
2018年第5期352-358,共7页
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
基金
解放军总医院科技创新苗圃基金（16KMM23）
关键词
下咽肿瘤
癌
鳞状细胞
手术
放化疗
综合治疗
Hypopharyngeal neoplasm
Carcinoma
squamous cell
Surgery
Chemoradiation
Combined modality therapy
