T1-2N0M0喉鳞癌单纯放射治疗患者的预后因素分析  

Prognosis characteristics of T1-2N0M0 laryngeal squamous cell carcinoma undergoing radiotherapy alone

作　　者：燕丽 王天 赵阳 邹丽芬 YAN Li;WANG Tian;ZHAO Yang;ZOU Lifen(Department of radiotherapy,Eye&ENT Hospital,Fudan University,Shanghai 200031,China)

机构地区：[1]复旦大学附属眼耳鼻喉科医院放疗科,上海200031

出　　处：《中国眼耳鼻喉科杂志》2023年第5期382-386,共5页Chinese Journal of Ophthalmology and Otorhinolaryngology

基　　金：上海市卫健委科研课题(20184Y0204)。

摘　　要：目的 探讨单纯放射治疗(简称放疗)的早期喉鳞癌患者的生存预后,为优化治疗方案提供参考。方法 回顾分析2010年1月1日—2018年12月31日及前瞻分析2019年1月1日—2021年12月31日期间病理确诊为T1-2N0M0喉鳞癌且在我科接受根治性放疗的患者的临床资料。采集患者的年龄、性别、分期、放疗方式、放疗剂量、免疫生化指标等信息,规律随访并统计患者的预后因素。结果 回顾入组患者95例,其中T1期76例、T2期19例;接受三维适形放疗(3-DCRT)93例、调强放疗(IMRT)2例;患者的1年、2年、5年总生存率(OS)分别为98.9%±1.1%、95.5%±2.2%、85.9%±4.0%。前瞻入组患者66例,其中T1期31例、T2期35例;一半以上患者接受容积调强放疗(VMAT);1年、2年OS分别为100%和97.2±2.7%,均优于回顾入组患者。年龄、分期、Ki67表达水平未对预后产生明显影响。结论 早期单纯放疗的喉癌患者,预后很好,而且随着放疗技术的改进,前瞻入组患者比回顾入组患者的远期预后更好。Objective To investigate the prognosis of patients with early-stage laryngeal squamous cancer who received radiotherapy alone in order to provide a reference for optimizing the treatment plan in the era of precise radiation.Methods Patients diagnosed with T1-2N0M0 laryngeal squamous cell carcinoma who received radical radiation in our department were retrospectively analyzed from January 1,2010 to December 31,2018 and prospectively analyzed from January 1,2019 to December 31,2021.Patients’basic information including age,gender stage,radiation methods,immunohistochemical markers were collected.Results A total of 95 patients were retrospectively enrolled,with 76 patients in T1 disease and 19 in T2 disease.Ninety-three patients received 3-dimensional conformal radiotherapy(3-DCRT),and two patients received intensity modulated radiotherapy(IMRT).The 1-year,2-year,and 5-year overall survival(OS)were 98.9%±1.1%,95.5%±2.2%,and 85.9%±4.0%,respectively.Sixty-six patients were prospectively enrolled,with 31 patients in T1 stage and 35 patients in T2 stage.More than half of the patients received volumetric-modulated arc therapy(VMAT).The 1-year and 2-year OS rates were 100.0%and 97.2%±2.7%,respectively(both better than that in the retrospective group).Age,stage,and Ki67 expression level did not affect long-term prognosis.Conclusions For laryngeal cancer patients with T1-2N0M0 disease,radiation alone produced an excellent prognosis.With improvement in radiotherapy techniques,patients in prospective group obtained a better prognosis compared with patients in the retrospective group.

关 键 词：T1-2N0M0喉鳞癌 放射治疗 回顾性研究 前瞻性研究 

分 类 号：R767.1[医药卫生—耳鼻咽喉科]