喉鳞癌患者预后影响因素的回顾性分析  

Retrospective analysis of prognostic factors in laryngeal squamous cell carcinoma

作　　者：郭修栋[1] 兰胜民[2] 曹建忠[2] 王宏卫[2] 罗宁[2] 鲁萍[2] 张红云[1] 李蓉[2] 

机构地区：[1]山西医科大学研究生学院,山西太原030001 [2]山西省肿瘤医院放疗中心,山西太原030013

出　　处：《中华肿瘤防治杂志》2011年第8期606-609,共4页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的:探讨术后放疗、化疗等辅助治疗对早晚期喉鳞癌患者预后的影响。方法:回顾性分析463例喉癌术后患者的临床病例资料。K-M法进行生存率的计算,Log-rank进行单因素分析,Cox回归行多因素分析。结果:463例喉鳞癌患者术后的中位生存时间为59.97个月,2和5年生存率分别为86.9%和50.1%,无瘤生存率为81.0%和43.0%。术后同步放化疗较术后放疗及单纯手术可以明显提高局部喉鳞癌术后患者的总生存率。单因素分析示,患者年龄、术后KPS评分、病理分期、肿瘤类型、放疗距手术时间、放疗剂量和治疗方案是影响患者生存的重要因素。多因素分析显示,年龄(χ2=7.349,P=0.007)、肿瘤分型(χ2=25.655,P=0.000)、治疗方案(χ2=15.231,P=0.000)及病理分期(χ2=77.880,P=0.000)是影响喉癌术后患者生存的独立因素。结论:早期喉癌患者术后辅助治疗未能提高生存率,可暂不做辅助放化疗,而局部晚期喉癌患者术后行同步放、化疗较术后放疗或单纯手术总生存率明显提高。OBJECTIVE： To evaluate the prognostic value of postoperative adjuvant therapy in patients with early and late laryngeal squamous cell carcinoma（LSCC）. METHODS： Four hundred and sixty-three patients with LSCC treated by different strategy after sur- gery were enrolled in further retrospective analysis. Survival analysis was performed by the K-M method, comparison among groups was performed by log-rank test and multivariate analysis was carried out with the Cox proportional hazard model. RESULTS： The median survival time was 59. 97 months, the 2- and 5-year survival rates were 86.9 % and 50.1 % respectively, and the 2- and 5-year diseaseffree survival rates were 81.0% and 43.0%. Postoperative concurrent radio-chemotherapy significantly could improve the overall survival in the patient with locally advanced laryngeal squamous cell carcinoma when compared with postoperative radiotherapy and surgery alone. Univariate analysis showed： age, KPS, pathology stage, tumor location, interval between surgery and radiotherapy, dose of radiation and treatment modality, were prognostic factors. Multivariate analysis showed that age （x^2 = 7. 349, P = 0. 007）, tumor location （x^2= 25. 655, P = 0. 000）, treatment modality （ ？（2 = 15. 231 ,P=0. 000）, pathology stage（x^2 =77. 880 ,P=0. 000） were inde- pendent prognostic factors. CONCLUSIONS.. Early staging laryngeal cancer patients do not need further postoperative treatment, while for locally advanced patients, postoperative concurrent ehemcrradiotherapy can sig- nificantly improve the overall survival compared with postoperative radiotherapy and surgery alone.

关 键 词：喉肿瘤 预后 因素分析 统计学 回顾性研究 

分 类 号：R739.65[医药卫生—肿瘤]