摘要
目的 探讨下咽鳞癌不同术前放射治疗剂量对综合治疗的影响。方法 回顾性分析2 0 1例 (男 181例 ,女 2 0例 ;年龄 32～ 75岁 )经术前放射治疗 +手术综合治疗 (R +S)的下咽鳞癌 (1997年UICC分期Ⅰ期 6例 ,Ⅱ期 14例 ,Ⅲ期 4 7例 ,Ⅳ期 134例 ) ,其中梨状窝 173例 ,咽后壁 19例 ,环后 9例。 12 4例术前放射治疗 4 0Gy ,77例术前放射治疗 5 0Gy ;放射治疗后 2周左右给予手术治疗。结果 术前放射治疗 4 0Gy组 5年生存率为 39.7% ,5 0Gy组为 5 5 .4 % (P <0 .0 5 )。术前放射治疗 4 0Gy组放射治疗相关性术后并发症发生率为 2 6 .6 % ,5 0Gy组为 15 .6 % (P <0 .0 5 )。术前放射治疗 4 0Gy组喉功能保留率为 38.7% ,5 0Gy组为 4 2 .9% (P >0 .0 5 )。术前放射治疗 4 0Gy组区域复发率为 2 8.2 % ,5 0Gy组为 2 9.9% (P >0 .0 5 )。结论 术前放射治疗 5 0Gy较 4 0Gy能提高下咽鳞癌的远期生存率 ,且不增加放射治疗引起的术后并发症 ,并有望增加喉功能的保留率。
ObjectiveTo discuss the effect of different preoperative radiotherapy doses in combined therapy for hypopharyngeal squamous cell carcinoma. Methods A retrospective analysis of 201 patients (sex:181 male,20 female;age:32～75 years) with hypopharyngeal squamous cell carcinoma treated from 1973 to 1998 by different doses of preoperative radiotherapy plus surgery was done. Of the 201 patients(stages Ⅰ,Ⅱ,Ⅲ,Ⅳ: 6,14,47,134),173 lesions originated from the pyriform sinus,19 from the posterior pharyngeal wall ,9 from the postcricoid lesion. Of the preoperative radiotherapy doses: 124 patients received 40 Gy and 77 received 50 Gy. They were all operated about two weeks after radiotherapy.Results The overall 5 year survival rates were 39.7% ,55.4% for 40 Gy and 50 Gy groups,respectively(P<0.05).The incidence of postoperative complication in relation to radiotherapy were 26.6%,15.6% for 40 Gy and 50 Gy groups,respectively(P<0.05). Preservation of laryngeal function was possible in 38.7%,42.9% for 40 Gy and 50 Gy groups,respectively(P>0.05).The regional recurrence rates were 28.2%,29.9% for 40 Gy and 50 Gy groups(P>0.05).Conclusions50 Gy preoperative radiotherapy is able to improve the long survival and raise hopefully the possibility of preserving laryngeal function,without increasing the incidence of postoperative complication as compared with 40 Gy dose group.
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
2004年第1期1-3,共3页
Chinese Journal of Radiation Oncology
关键词
术前放射治疗
放射剂量
下咽鳞癌
综合治疗
手术疗法
Hypopharyngeal neoplasms/radiotherapy
Radiotherapy,preoperative
Hypopharyngeal neoplasms/surgery
Prognosis
