诱导化疗在下咽中晚期鳞状细胞癌中的应用研究  

Application of induction chemotherapy in middle and local advanced squamous cell carcinoma of hypopharynx

作　　者：卫亚楠 陈海兵[1] 陈若希[1] 徐进[1] 陈曦[1] WEI Yanan;CHEN Haibing;CHEN Ruoxi;XU Jin;CHEN Xi(Department of Otorhinolaryngology,The First Affiliated Hospital,Nanjing Medical University,Nanjing 210029,Jiangsu,China)

机构地区：[1]南京医科大学第一附属医院江苏省人民医院耳鼻咽喉科,南京210029

出　　处：《中国中西医结合耳鼻咽喉科杂志》2022年第3期193-198,共6页Chinese Journal of Otorhinolaryngology in Integrative Medicine

基　　金：江苏省卫生健康委(H2018013)。

摘　　要：目的探究诱导化疗在中晚期下咽鳞状细胞癌治疗中的应用价值。方法回顾性分析54例下咽鳞癌患者治疗方式,其中诱导化疗组22例,化疗结束后达到疾病稳定及以上患者序贯同步放化疗或放疗,否则行手术治疗;手术组32例,其中行全喉切除20例,部分喉切除12例,术后辅助放疗或同步放化疗。比较两组的生存时间、无进展生存期、保喉率及不良事件发生率。结果随访时间4至58个月,中位随访时间18.5个月,诱导组中位生存时间10个月,中位无进展生存期10个月,手术组中位生存时间20个月,中位无进展生存期18个月,生存分析曲线提示10个月时诱导组生存率93.3%,无进展生存率93.3%,手术组生存率90.6%,无进展生存率86.7%,无统计学差异。截至随访结束,诱导组保喉率100%,手术组保喉率37.5%。诱导组最常见血液系统不良事件,其中3级2例,对患者依从性无影响。结论中晚期下咽鳞癌患者行诱导化疗,根据缓解率选择序贯治疗方案,在不降低患者生存率的前提下,最大程度上保留患者喉功能,提高了患者生存质量,可成为下咽鳞状细胞癌患者治疗的重要手段。Objective The aim of this study was to evaluate the value of induction chemotherapy(IC)in the treatment of middle and locally advanced hypopharyngeal squamous cell carcinoma..Subjects and Methods 54 patients with SCC who underwent ICT(n=22)or SRT(n=32)were enrolled in the study,comparing the prognosis,larynx preservation rate and incidence of adverse events of IC followed by(chemo)radiotherapy(ICT)with surgery-based therapy(SRT).Results The follow-up time was 4 to 58 months,the median follow-up time was 20 months,the median progression-free survival(PFS)and median overall survival(OS)for ICT were both 10 months,18 months and 20 months,respectively for SRT.Survival curve showed that at 10 months,the OS rates were 93.3%for ICT,90.6%for SRT,the PFS rates were 93.3%for ICT,86.7%for SRT,there was no statistical difference.The final laryngeal preservation rate was significantly lower in the SRT group(37.5%)than in the ICT(100%).The most common adverse event was abnormal blood system for ICT,including 2 cases of G3,had no effect on patient compliance.Conclusion Induction chemotherapy can be an important treatment method for patients with SCC and sequential treatment can be selected according to the remission rate,so as to retain the laryngeal function to the greatest extent and improve the quality of life of patients without decreasing the survival rate.

关 键 词：中晚期头颈部鳞癌 化疗 诱导 手术 综合治疗 

分 类 号：R739.63[医药卫生—肿瘤]