低温等离子射频消融术治疗早期声门型喉癌的疗效及影响因素分析  

Analysis of the efficacy and influencing factors of hypothermic plasma radiofrequency ablation in the treatment of early glottic carcinoma

作　　者：侯彬[1] 黄维平[1] 尹中普[1] 刘永刚[1] HOU Bin;HUANG Weiping;YIN Zhongpu;LIU Yonggang(Department of Otolaryngology,Nanyang Central Hospital,Nanyang 473000,He’nan,China)

机构地区：[1]南阳市中心医院耳鼻喉科,河南南阳4730000

出　　处：《癌症进展》2021年第13期1345-1348,1358,共5页Oncology Progress

摘　　要：目的探讨低温等离子射频消融术治疗早期声门型喉癌的疗效及相关影响因素。方法根据手术方式的不同将120例早期声门型喉癌患者分为等离子组(n=86)和传统组(n=34),其中等离子组患者采用支撑喉镜下低温等离子射频消融术,传统组患者采用传统喉裂开声带切除术。所有患者手术结束后均采用门诊复查与电话随访相结合的方式进行3年随访。统计两组患者的术后喉功能保存率及1年、3年局部控制率,分析低温等离子射频消融术治疗早期声门型喉癌疗效的影响因素。结果等离子组患者的术后喉功能保存率高于传统组,差异有统计学意义(P﹤0.05);两组患者的术后1年、3年局部控制率比较,差异均无统计学意义(P﹥0.05)。单因素分析结果显示,性别、年龄、临床分期、肿瘤分化程度、术前卡氏功能状态(KPS)评分、浸润方向均可能与接受低温等离子射频消融术治疗的早期声门型喉癌患者的3年局部控制率有关(P﹤0.05);Cox多因素回归分析结果显示,年龄、临床分期、术前KPS评分、浸润方向向下累及声门下均是接受低温等离子射频消融术治疗的早期声门型喉癌患者3年局部控制率的独立影响因素(P﹤0.05)。结论采用低温等离子射频消融术治疗早期声门型喉癌能够在尽可能提高术后喉功能保存率的情况下,取得与传统手术相当的疗效,其治疗效果与多项因素有关,临床可按需选择适宜的手术时机及手术方案,改善手术疗效。Objective To investigate the efficacy and influencing factors of hypothermic plasma radiofrequency ablation in the treatment of early glottic carcinoma.Method 120 patients with early glottic carcinoma were divided into the plasma group(n=86,treated with hypothermic plasma radiofrequency ablation under supporting laryngoscope)and traditional group(n=34,treated with traditional laryngectomy)according to different surgeries.All patients were followed up for 3 years by the combination of outpatient reexamination and telephone calls.The postoperative laryngeal function preservation rate and 1-year and 3-year local control rate of the two groups were calculated,and the factors affecting the efficacy of hypothermic plasma radiofrequency ablation in the treatment of early glottic carcinoma were analyzed.Result The postoperative laryngeal function preservation rate of the plasma group was significantly higher than that of the traditional group(P<0.05),but there was no significant difference in the 1-year and 3-year local control rate after operation between the two groups(P>0.05).Univariate analysis showed that sex,age,clinical stage,tumor differentiation degree,preoperative score of Karnofsky performance status(KPS)and invasion direction might be related to the 3-year local control rate of early glottic carcinoma patients treated with hypothermic plasma radiofrequency ablation(P<0.05).Cox multivariate regression analysis showed that age,clinical stage,preoperative KPS score and downward invasion involving the subglottis were independent influencing factors of 3-year local control rate of early glottic carcinoma patients treated with hypothermic plasma radiofrequency ablation(P<0.05).Conclusion The treatment of early glottic carcinoma patients with hypothermic plasma radiofrequency ablation can improve the preservation rate of laryngeal function,and the efficacy is comparable to that of traditional operation.The efficacy is related to many factors.The appropriate operation time and scheme can be selected according to the

关 键 词：早期声门型喉癌 低温等离子射频消融术 局部控制率 影响因素 

分 类 号：R739.65[医药卫生—肿瘤]