手术联合放射治疗与单纯喉部分切除术治疗喉癌的临床对照研究  

Clinical Control Study of Partial Laryngectomy Combined with Radiotherapy in the Treatment of Laryngeal Carcinoma

作　　者：洪朝欣 罗丹凤[1] 陈秋桂 张江灵[1] 陈云萍[1] 

机构地区：[1]解放军第180医院,362000

出　　处：《实用癌症杂志》2018年第2期221-223,共3页The Practical Journal of Cancer

摘　　要：目的探讨手术联合放射治疗与单纯喉部分切除术治疗喉癌的的临床疗效。方法选取80例喉癌患者,随机数字表法分为2组。观察组患者(40例)给予手术联合放射治疗,对照组患者(40例)行喉部分切除术。观察并记录2组患者3年生存率,死亡原因,术前和术后3个月SF-36量表评分,评价手术联合放射治疗与单纯喉部分切除术治疗喉癌的临床疗效。结果随访3年期间,Ⅰ期、Ⅱ期2组患者存活率相比,无统计学差异(P>0.05);Ⅲ、Ⅳ期2组患者存活率相比,有统计学差异(P<0.05)。11例患者死于原发灶复发,5例死于颈淋巴结复发,3例死于远处转移,合计死亡例数19例。术前2组SF-36量表各项得分相比,差异没有统计学意义(P>0.05);术后3个月,2组SF-36各项评分均明显提高(P<0.05),但2组间SF-36各项评分无统计学差异(P>0.05)。结论与单纯喉部分切除术相比,手术联合放射治疗对Ⅲ、Ⅳ期喉癌患者具有一定疗效,可提高患者生存率,但对Ⅰ期、Ⅱ期喉癌患者优势不明显。手术加放射治疗与单纯手术治疗均可提高患者生活质量。Objective To discuss the efficacy of partial laryngectomy combined with radiotherapy in the treatment of laryngeal carcinoma. Methods 80 cases with laryngeal carcinoma were selected. They were randomly divided into 2 groups. The observation group （40 cases） was treated with partial laryngectomy combined with radiotherapy. The control group（40 cases） was treated with partial laryngectomy. The efficacy of partial laryngectomy combined with radiotherapy in the treatment of laryngeal carcinoma was evaluated by 3-year survival rate, causes of death, preoperative and postoperative SF-36 scores. Results During 3- year follow-up, there was no significant difference in survival rates between the 2 groups （ P 〉 0.05 ）. The survival rates of the patients in group Ⅲ and Ⅳ were statistically different between the 2 groups （ P 〈 0.05）. 11 patients died of primary recurrence, 5 patients died of recurrence of cervical lymph node, and 3 patients died of distant metastasis, with a total mortality of 19 cases. Compared with the preoperative SF-36 scale scores between the 2 groups, the difference was not statistically significant （ P 〉 0.05 ）. 3 months after surgery, SF-36 scores of the 2 groups were significantly improved（ P 〈 0. 05 ）. But SF-56 scores had no statistical difference between the 2 groups（P 〉 0.05 ）. Conclusion Compared with the simple partial laryngectomy, partial laryn-gectomy combined with radiotherapy has better effect for stage Ⅲ and Ⅳ laryngeal cancer by improving the survival rate of patients, but has no advantage on patients with stage Ⅰ, Ⅱ. Both of them can improve the quality of life for patients.

关 键 词：放射治疗 喉部分切除术 喉癌 生活质量 

分 类 号：R739.65[医药卫生—肿瘤]