以手术切除为主的序贯综合治疗方案对局部晚期口腔癌的临床疗效  

The Clinical Efficacy of a Sequential Comprehensive Treatment Plan Mainly Based on Surgical Resection for Locally Advanced Oral Cancer

作　　者：韩小琴 周俊年 李小军 李东山 王健 HAN Xiaoqin;ZHOU Junnian;LI Xiaojun;LI Dongshan;WANG Jian(Otolaryngology Head and Neck Surgery,Gansu Wuwei Cancer Hospital,Wuwei 733000,Gansu Province,China;The Fifth Radiotherapy Department,Gansu Wuwei Cancer Hospital;Personnel Department,Gansu Wuwei Cancer Hospital)

机构地区：[1]武威肿瘤医院耳鼻喉头颈外科,甘肃武威733000 [2]武威肿瘤医院放疗五科 [3]武威肿瘤医院人事科

出　　处：《中国实用乡村医生杂志》2023年第12期64-67,共4页Chinese Practical Journal of Rural Doctor

基　　金：武威市市列科技计划项目,项目编号:WW2020050。

摘　　要：目的 探讨以手术切除为主的序贯综合治疗方案对局部晚期口腔癌的临床疗效。方法 收集甘肃省武威肿瘤医院2017年1月—2021年12月收治的局部晚期口腔癌患者89例,分为手术组61例和非手术组28例。手术组术前接受新辅助化疗,术中视情况进行皮瓣修复,术后接受放疗;而非手术组接受同步化疗联合放疗。比较手术、新辅助化疗和皮瓣修复对预后的影响。结果 治疗后,手术组癌胚抗原、神经元特异性烯醇化酶、糖类抗原-199低于非手术组,差异有统计学意义(P<0.05)。手术组生存时间长于非手术组(中位25.3个月vs.中位19.4个月),差异有统计学意义(P<0.05)。新辅助化疗方案,TPF亚组与DBF亚组疾病控制率(60.6%vs. 53.57%)和生存时间(中位27.6个月vs.中位24.0个月)差异无统计学意义(P>0.05)。修复亚组生存时间(中位28.6个月vs.中位25.0个月)长于非修复亚组,差异有统计学意义(P<0.05)。结论 以手术切除为主的序贯综合治疗方案相比于非手术治疗,能够延长局部晚期口腔癌患者的生存期,皮瓣修复能进一步改善手术切除效果;但不同新辅助化疗方案对术前肿瘤控制和生存期的改善差异不明显。Objective To explore the clinical efficacy of a sequential comprehensive treatment plan mainly based on surgical resection for locally advanced oral cancer.Methods A total of 89 patients with locally advanced oral cancer admitted to Wuwei Cancer Hospital in Gansu Province from January 2017 to December 2021 were collected,and divided into a surgical group of 61 cases and a non-surgical group of 28 cases.The surgical group received neoadjuvant chemotherapy before surgery,skin flap repair during surgery,and radiation therapy after surgery.The nonsurgical group received synchronous chemotherapy combined with radiotherapy.The effects of surgery,neoadjuvant chemotherapy,and skin flap repair on prognosis were compared.Results After treatment,carcinoembryonic antigen,neuron specific enolase and carbohydrate antigen-199 in the operation group were significantly lower than those in the non operation group(P<0.05).The survival time of the surgical group was significantly longer than that of the non-surgical group(median 25.3 months vs.median 19.4 months)(P<0.05).The disease control rate(60.6%vs.53.57%)and survival time(median 27.6 months vs.median 24.0 months)between the TPF subgroup and DBF subgroup in the neoadjuvant chemotherapy regimen were not significant(P>0.05).The survival time of the repair subgroup(median 28.6 months vs.median 25.0 months)was significantly longer than that of the non repair subgroup(P<0.05).Conclusion Compared with non-surgical treatment,the sequential comprehensive treatment plan mainly based on surgical resection can prolong the survival time of locally advanced oral cancer patients,and skin flap repair can further improve the surgical resection effect.However,there is no significant difference in the improvement of preoperative tumor control and survival among different neoadjuvant chemotherapy regimens.

关 键 词：口腔癌 手术 化疗 放疗 修复 综合治疗 

分 类 号：R739.85[医药卫生—肿瘤]