经口激光治疗下咽癌疗效单组率的Meta分析  

Meta-Analysis of Single-Group Rates of the Efficacy of Transoral Laser Microsurgery for Hypopharyngeal Cancer

作　　者：丁硕 黄俊伟[1,2] 钟琦 张洋[1,2] 郭伟[1,2] 黄志刚[1,2] Ding Shuo;Huang Junwei;Zhong Qi;Zhang Yang;Guo Wei;Huang Zhigang(Department of Otolaryngology-Head and Neck Surgery,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China;Key Laboratory of Otolaryngology-Head and Neck Surgery(Ministry of Education),Beijing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院耳鼻咽喉头颈外科,北京100730 [2]耳鼻咽喉头颈科学教育部重点实验室,北京100730

出　　处：《肿瘤预防与治疗》2022年第3期226-234,共9页Journal of Cancer Control And Treatment

摘　　要：目的:系统评价经口激光(transoral laser microsurgery,TLM)治疗下咽癌喉功能保存率以及肿瘤预后。方法:检索PubMed、Embase、Web of Science、Springer、中国知网、万方数据和SinoMed数据库中公开发表的关于下咽癌TLM治疗的文献,检索时限为1970年至2019年6月31日。采用RevMan 5.3软件进行单组率Meta分析。结果:共纳入15篇文献,994名患者参与了研究。Meta分析结果显示:5年喉功能保存率为91%(95%CI:0.86~0.94),5年总生存率为54%(95%CI:0.50~0.58),5年疾病特异性生存率为72%(95%CI:0.69~0.75),5年无复发生存率为55%(95%CI:0.50~0.60),5年局部控制率为77%(95%CI:0.74~0.80),T1+T2期患者局部控制率与T3+T4期患者5年局部控制率比较有统计学差异(85%vs 72%,P=0.025)。结论:TLM治疗针对部分下咽癌患者是一种有效的治疗方法,其保喉率高,肿瘤治疗效果好。除此以外,TLM结合颈部淋巴结清扫以及放化疗也可获得满意的治疗效果,但对晚期下咽癌患者的治疗要慎重选择。Objective:To evaluate the preservation rate and long-term oncologic outcome of hypopharyngeal carcinoma patients treated by transoral laser microsurgery(TLM)through systematic review.Methods:Literature for hypopharyngeal carcinoma treated by TLM from 1970 to June 31,2019 was searched from PubMed,Embase,Web of Science,Springer LINK,CNKI,Wanfang Data and SinoMed databases.Single-group rate meta-analysis was performed with RevMan 5.3 software.Results:In total,994 patients were included from 15 literatures.The 5-year laryngeal preservation rate was 0.93%(95%CI:0.86-0.94);the 5-year overall survival was 54%(95%CI:0.50-0.58);the 5-year disease-specific survival was 76%(95%CI:0.69-0.75);the recurrence-free survival was(95%CI:0.50-0.60);the 5-year local control was 77%(95%CI:0.74-0.80).The 5-year local control between T1+T2 and T3+T4 patients was statistically different(72%vs 85%,P=0.025).Conclusion:Laser treatment is effective for patients with hypopharyngeal carcinoma with high preservation rate and favorable prognosis.TLM+lymph node detection in the neck+chemotherapy can achieve satisfactory results.However,it is recommend to be cautious about applying TLM to patients with advanced hypopharyngeal cancer.

关 键 词：下咽癌 经口激光 META分析 

分 类 号：R739.65[医药卫生—肿瘤] R739.63[医药卫生—临床医学]