中晚期上颌窦鳞癌不同治疗方法临床疗效研究  

Clinical efficacy of different treatment methods on moderate and advanced maxillary sinus squamous cell carcinoma

作　　者：张令 邵渊[1] 牛国华 ZHANG Ling;SHAO Yuan;NIU Guohua(Department of Otorhinolaryngology-Head and Neck Surgery,the First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061,China)

机构地区：[1]西安交通大学第一附属医院耳鼻咽喉头颈外科,陕西西安710061 [2]铜川市耀州区人民医院耳鼻喉科,陕西铜川727100

出　　处：《陕西医学杂志》2023年第4期423-427,共5页Shaanxi Medical Journal

基　　金：陕西省自然科学基础研究计划面上项目(2023-JC-YB-791)。

摘　　要：目的:比较不同治疗方法对中晚期上颌窦鳞状细胞癌(MSSCC)的临床疗效。方法:将收治的82例中晚期MSSCC患者随机分为两组:第一组患者采用鼻内镜辅助切除+切除后根治性放疗,即传统治疗组;第二组采用手术前诱导化疗+手术切除+切除后放疗的综合治疗,即综合治疗组。通过回顾性分析,比较两组患者的治疗有效率、术后并发症和5年生存率(病例随访5年以上,5年内死亡病例随访至死亡日)。结果:所有82例MSSCC病例均定期随访,随访率为100%。综合治疗组和传统治疗组的治疗有效率分别为87.8%和53.7%,组间比较差异有统计学意义(P<0.05)。随后,我们对两组患者的术后并发症进行比较,两组的术后并发症发生率均无统计学差异。5年中,所有患者死亡病例数为44例,总生存率为46.4%(38/82),其中传统治疗组的41例中,有30例患者死亡,生存率为26.8%(11/41);在综合治疗组的41例患者中,有14例患者死亡,生存率为65.9%(27/41),两组生存率的比较差异有统计学意义(P<0.05)。结论:相比于传统治疗方案,综合治疗组在术前增加诱导化疗可明显降低MSSCC的病死率,因此术前行诱导化疗是治疗MSSCC的一种有效治疗方法。术前化疗可以有效缩小瘤体,降低手术风险,且未增加术后并发症,为手术治疗提供了保障。Objective:To investigate effects of different treatment methods on moderate and advanced maxillary sinus squamous cell carcinoma(MSSCC).Methods:The 82 patients with moderate and advanced MSSCC were divided into two groups.The group received the traditional endoscopic-assisted resection and radical radiotherapy was regarded as traditional treatment group.The group received comprehensive treatment of preoperative induction chemotherapy and surgical resection and postoperative radiotherapy was regarded as comprehensive treatment group.The curative effective rates,postoperative complications and 5-year survival rate of two groups were compared(cases were followed up for more than 5 years,and those who died within 5 years were followed up to the day of death).Results:Among the 82 cases with MSSCC,all cases were followed up regularly,and the follow-up rate was 100%.The curative effective rates of the comprehensive treatment group and traditional group were 87.8%and 53.7%,respectively.There were no significant difference in the postoperative complications between two groups.During the 5 years period,44 of the 82 patients died,and the overall survival rate was 46.4%(38/82).Among the 41 patients in traditional treatment group,30 died,and the survival rate was 26.8%(11/41);while among the 41 cases in the comprehensive treatment group,14 patients died,and the survival rate was 65.9%(27/41).The difference of survival rate between the two groups was statistically significant(P<0.05).Conclusion:Compared with the traditional treatment,the addition of preoperative induction chemotherapy in the comprehensive treatment group can significantly reduce the mortality of MSSCC.Therefore,preoperative induction chemotherapy is an effective treatment method for MSSCC.Preoperative chemotherapy can effectively shrink the tumor,reduce the risk of surgery,and does not increase postoperative complications,which provides a guarantee for surgical treatment.

关 键 词：中晚期上颌窦鳞癌 鼻内镜辅助切除 术前诱导化疗 综合治疗 治疗效果 生存率 

分 类 号：R739.6[医药卫生—肿瘤]