下咽癌椎前间隙侵犯对预后的影响  

Prognostic impact of prevertebral space involvement in hypopharyngeal carcinoma

作　　者：方莎 郑林惠 蔡文启 向文彬 祁琰 吴华超 吴朝妍[4] 於海军[1,2,3] FANG Sha;ZHENG Linhui;CAI Wenqi;XIANG Wenbin;QI Yan;WU Huachao;WU Chaoyan;YU Haijun(Dept.of Radiation and Medical Oncology,Zhongnan Hospital of Wuhan University,Wuhan 430071,Hubei,China;Hubei Cancer Clinical Study Center,Zhongnan Hospital of Wuhan University,Wuhan 430071,Hubei,China;Hubei Key Laboratory of Tumor Biological Behaviors,Zhongnan Hospital of Wuhan University,Wuhan 430071,Hubei,China;Dept.of Integrated Traditional Chinese Medicine and Western Medicine,Zhongnan Hospital of Wuhan University,Wuhan 430071,Hubei,China)

机构地区：[1]武汉大学中南医院放射肿瘤科,湖北武汉430071 [2]武汉大学中南医院、湖北省肿瘤临床研究中心,湖北武汉430071 [3]武汉大学中南医院、湖北省肿瘤生物学行为重点实验室,湖北武汉430071 [4]武汉大学中南医院中西医结合科,湖北武汉430071

出　　处：《武汉大学学报(医学版)》2025年第1期48-55,共8页Medical Journal of Wuhan University

基　　金：国家自然科学基金资助项目(编号:82073349);湖北省自然科学基金资助项目(编号:2018CFB561)。

摘　　要：目的:报道下咽癌患者椎前间隙侵犯的发生率并评估其预后价值。方法:回顾性分析2014年1月至2022年6月在武汉大学中南医院接受治疗的初治下咽癌患者的临床资料,将总生存期(OS)、无进展生存期(PFS)、局部无复发生存期(LRFS)、疾病进展时间(TTP)作为临床终点,对比有无椎前间隙侵犯患者的生存期。结果:在初治的下咽癌患者中,有椎前间隙侵犯的发生率为51.4%(57/111),85例患者中有25例(29.4%)在随访期间出现疾病进展,其中60.0%(15/25)的患者为局部复发,在所有接受调强放疗(IMRT)的患者中,无椎前间隙侵犯与有椎前间隙侵犯的下咽癌患者5年OS、PFS分别为31.7%和37.5%(P<0.05),20.1%和37.2%(P<0.05),肿瘤侵犯环后区、咽后壁和椎前间隙均与较差的预后有关。结论:在下咽癌患者中,有椎前间隙侵犯是预后不良的标志,有椎前间隙侵犯的患者应得到足够重视。Objective:To report the incidence and to evaluate the prognostic significance of prevertebral space involvement(PSI)in patients with hypopharyngeal carcinoma(HPC).Methods:The clinical data of the patients with pharyngeal cancer who received treatment at Zhongnan Hospital of Wuhan University from January 2014 to June 2022 were retrospectively analyzed.Overall survival(OS),progression-free survival(PFS),local relapse-free survival(LRFS),and time to progression(TTP)were recorded as clinical endpoints to evaluate the prognosis of patients with or without PSI.Results:The incidence rate of PSI was 51.4%(57/111)in newly diagnosed HPC patients.Twenty-five in eighty-five(29.4%)patients developed disease recurrence during the follow-up,and 60.0%(15/25)were lo-cal relapses.In the patients who received intensity-modulated radiotherapy(IMRT),the 5-year OS,PFS for the HPC patients with vs without PSI was 31.7%vs 37.5%(P<0.05)and 20.1%vs 37.2%(P<0.05),respectively.The primary tumor extension of the post-cricoid region,posterior pharyngeal wall,and prevertebral space are associated with poorer prognosis.Conclusion:Among HPC patients,PSI predicts a poor prognosis.It seems reasonable that the prevertebral space should be given as much attention as the post-cricoid region and the posterior pharyngeal wall in HPC patients.

关 键 词：下咽癌 椎前间隙 磁共振成像 调强放疗 

分 类 号：R739[医药卫生—肿瘤]