喉声门型癌Ⅲ期病变临床治疗  

The treatment of T3N0M0 glottic squamous cell carcinoma

作　　者：邢海杰[1] 曾宗渊[1] 陈福进[1] 伍国号[1] 杨安奎[1] 

机构地区：[1]华南肿瘤学国家重点实验室,中山大学肿瘤防治中心头颈科,广东广州510060

出　　处：《中国耳鼻咽喉头颈外科》2006年第4期207-210,共4页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的比较不同治疗方案对喉声门型癌T3N0M0病变预后的影响,优化临床治疗。方法分析1992年～1999年我院采用喉垂直部分切除术、喉全切除术和根治性放射治疗等方案治疗的65例喉声门型癌T3N0M0病变的临床资料,比较不同治疗的总体生存率、原发部位及颈部淋巴结复发率和喉功能保留率。结果Cox分析显示三种治疗方案的总体生存率、原发部位和颈部淋巴结复发率无显著性差异(P>0.05);喉垂直部分切除术和根治性放射治疗的喉功能保存率高,差异有显著性(P<0.01)。结论三种方案治疗喉声门型癌T3N0M0病变,总体生存率和复发率无差异,喉垂直部分切除术和根治性放疗有利于保留喉功能。OBJECTIVE To assess the outcomes of three different therapeutic approaches for the treatment of T3N0M0（stage Ⅲ） glottic squamous cell carcinoma. METHODS Sixty-five cases of T3N0M0 glottic squamous cell carcinoma treated with curative intent by three different modalities include vertical hemilaryngectomy（VHL,n=21 ）,total laryngectomy （TL,n=31）and radiotherapy（RT, n=13） were reviewed retrospectively. The survival rate,recurrence rate at the primary lesion site and jugular lymph node, and laryngeal preservation was compared among three methods. RESULTS There was no significant difference in the overall survival rates（Cox proportion hazard model） and recurrence rates at the primary lesion site or jugular lymph node among the three methods. Laryngeal function was preserved in 100% of the cases in the VHL and RT groups after initial treatment. CONCLUSION The three treatment modalities had statistically similar survival and recurrence rates. Patients treated with VHL and RT had a higher rate of laryngeal preservation compared to that of TL, hence VHL or RT is a valid alternative to TL in treating selected patients with T3N0M0 glottic squamous cell carcinoma.

关 键 词：喉肿瘤 癌 鳞状细胞 喉切除术 放射疗法 计算机辅助 

分 类 号：R739.65[医药卫生—肿瘤] R563.1[医药卫生—临床医学]