手术与非手术治疗晚期喉鳞癌的生存比较  

Effect of Surgery and Non-surgical Treatment on the Survival of Patients with Advanced Laryngeal Squamous Cell Carcinoma

作　　者：张欣睿[1] 刘学奎[1] 李铨[1] 郭朱明[1] 张诠[1] 杨安奎[1] 曾宗渊[1] 

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

出　　处：《中国肿瘤临床》2011年第21期1342-1345,共4页Chinese Journal of Clinical Oncology

基　　金：广东省科技计划项目(编号:20118031800221)资助

摘　　要：目的:评价晚期喉鳞癌手术和非手术治疗的疗效。方法:回顾性分析1990年1月至2005年12月中山大学肿瘤防治中心312例晚期喉鳞癌住院患者资料,分为手术组238例(76.3%)和非手术组74例(23.7%)。比较手术组和非手术组5年累积生存率;分层比较Ⅲ/Ⅳ期手术组和非手术组5年累积生存率。结果:全组总的5年累积生存率为50.1%。手术组和非手术组5年累积生存率分别为56.6%和30.3%,经Log-rank检验,差异有统计学意义(P<0.001)。Ⅲ期手术组和非手术组5年累积生存率分别为65.4%和47.5%,经Log-rank检验,差异无统计学意义(P=0.222)。Ⅳ期手术组和非手术组5年累积生存率分别为44.7%和21.5%,经Log-rank检验,差异有统计学意义(P=0.013)。结论:本研究结果证实Ⅳ期喉鳞癌(尤其是T_4期)的手术治疗疗效优于非手术治疗;颈部淋巴结阴性时(N_0期),治疗方法是影响T_4期喉鳞癌生存率的唯一因素。Objective： To evaluate the effect of primary surgical and non-surgical treatment on the survival of advanced laryngeal squamous cell carcinoma （ LSCC ） patients. Methods： From 1990 to 2005, 312 patients with advanced LSCC and hospitalized at the Cancer Center of Sun Yat-Sen University were reviewed retrospectively. A total of 238 （ 76.3% ） received surgical treatment, while 74 （ 23.7% ） received non-surgical treatment. The 5-year accumulative survival rates for both groups were estimated. Then, the 5-year accu- mulative survival rates of patients with LSCC at stages III or IV were compared. Results： The overall 5-year accumulative survival rate was 50.1%. The 5-year accumulative survival rates of the surgical and non-surgical groups were 55.6% and 30.3% （ P〈 0.001 ）, respectively. The 5-year accumulative survival rates of both groups with stage III disease were similar （ 65.4% vs. 47.5%, P = 0.222 ）, and no difference was found between them. However, the 5-year accumulative survival rate of the surgical group with stage IV disease was significantly better that of the non-surgical group with stage IV disease （ 44.7% vs. 21.5%, P = 0.013 ）, A significant difference between these groups was also found. Conclusion： The results of the present study demonstrate that the survival rate of the surgical group is better than that of the non-surgical group in patients with stage IV laryngeal cancer, and, specifically, T4 primary tumors. When the cervical lymph node is negative （No）, treatment is the only factor that influences the survival rate of patients with T4 tumors.

关 键 词：喉肿瘤 鳞状细胞癌 手术 非手术 放化疗 

分 类 号：R739.65[医药卫生—肿瘤]