晚期喉咽癌术后综合治疗的疗效及生存分析  

Clinical study and survival analysis of combined modality therapiesfor advanced hypopharyngeal carcinoma

作　　者：施清圆[1] 李文峰[2] 李刚[2] 张春鸿[1] 方潇碧[1] 吴丽萍[1] 张露[1] 廖志苏[1] 

机构地区：[1]温州医学院附属第一医院耳鼻咽喉科,浙江温州325000 [2]温州医学院附属第一医院放化疗科

出　　处：《临床耳鼻咽喉头颈外科杂志》2013年第4期206-209,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:评价晚期喉咽癌术后辅助综合治疗的疗效,探讨提高喉咽癌患者生活质量及生存率的方法。方法:76例男性Ⅲ～IV期喉咽癌患者接受术后辅助治疗,其中44例进行术后单纯放疗,32例接受术后同步放化疗。结果:通过Kaplan-Meier法进行生存分析,其中术后单纯放疗组患者5年总生存率为25.9%,术后同步放化疗组为27.8%,两组比较差异无统计学意义(P>0.05)。术后单纯放疗组3年和5年的肿瘤无复发生存率分别为36.0%和22.5%,而术后同步放化疗组分别为68.0%和45.3%,两组比较差异有统计学意义(P<0.05)。按照NCI.CTC3.0版标准评价,两组的毒性反应主要有疲乏、白细胞减少、血小板下降、局部皮肤发红脱屑、脱发等,C3/4级的毒副反应共有14例,其中9例肺部感染,2例为放射性头痛,3例为白细胞及血小板下降。术后单纯放疗组及术后同步放化疗组的C3/4级毒副反应分别为6例和8例,两组间比较,差异无统计学意义(P>0.05)。结论:对于晚期喉咽癌,术后同步放化疗相比于术后单纯放疗可以提高患者无复发生存率,改善生活质量,同时并没有增加患者治疗的毒副反应。Objective：To evaluate the efficacy of combined modality therapy for advanced hypopharyngeal carcinoma in order to improve the curative effect of hypopharyngeal carcinoma.Method：Seventy-six male patients with the stage Ⅲ-Ⅳ hypopharyngeal carcinoma were treated with postoperative combined modality.Of all the 76 cases,44 were treated with postoperative radiotherapy,and the other 32 treated with chemoradiotherapy concurrently.Result：Kaplan Meier analysis indicated that the overall 5 survival rates of patients treated with postoperative radiotherapy was 25.9%,and that of patients treated with postoperative chemoradiotherapy was 27.8%.There was no significant difference between the two groups（P0.05）.Three and five years relapse-free survival rates of the patients treated with postoperative radiotherapy were 36.0%,22.5%,and those of the patients treated with postoperative chemoradiogtherapy were 68.0%,45.3%.Significant difference was calculated between the two groups（P0.05）.According to the NCI CTC3.0 criteria,the toxicities on grade 3 or above of the two groups showed no significant difference（P0.05）.Conclusion：For advanced hypopharyngeal carcinoma,postoperative chemoradiotherapy yielded satisfactory relapse free survival and laryngeal function preservation rate which was superior to that of postoperative radiotherapy.Also the treatment toxicities were not increased.

关 键 词：喉咽肿瘤 同步放化疗 综合治疗 生存率 

分 类 号：R739.65[医药卫生—肿瘤]