321例下咽癌患者临床特征及两种治疗方式疗效分析

路铁; 李振东; 李树春; 李延国; 刘宏伟; 姜力; 黄冬宁; 魏宏明; 刘翥

doi:10.13201/j.issn.1001-1781.2019.03.022

321例下咽癌患者临床特征及两种治疗方式疗效分析

- 中国医科大学肿瘤医院辽宁省肿瘤医院头颈外科(沈阳, 110042)

详细信息

通讯作者: 李振东,E-mail:1349946150@qq.com

中图分类号: R739.63

收稿日期: 2018-10-10

The clinical characteristics and two different treatment outcomes of 321 patients with hypopharyngeal squamous cell carcinoma

- Department of Head and Neck Surgery, Cancer Hospital of China Medical University, Liaoning Tumour Hospital, Shenyang, 110042, China

More Information

Corresponding author: LI Zhendong, E-mail: 1349946150@qq.com

Received Date: 10 October 2018

摘要

摘要: 目的:分析下咽鳞状细胞癌的临床特点、治疗效果及预后影响因素。方法:采用寿命表计算321例下咽鳞状细胞癌患者的总生存率,Kaplan-Meier法进行生存分析,组间差异采用Log-rank法检验,交叉表格法比较两种治疗方式的保喉率。Cox回归模型分析预后的独立影响因素。结果:321例患者中,采用手术+术后综合治疗197例,非手术综合治疗124例。全部患者1年、3年、5年总生存率分别为75.87%、49.39%和41.38%,中位生存时间为37.65个月。非手术综合治疗保喉率(41.94%)与手术+术后综合治疗保喉率(11.17%)比较,差异有统计学意义(P<0.01)。单因素分析显示肿瘤临床分期、T分期、N分期、M分期、治疗方式对患者生存预后的影响具有统计学意义。Cox回归模型多因素分析显示生存率的独立影响因素为肿瘤T分期、N分期和治疗方式。结论:下咽癌仍是疗效较差的头颈部恶性肿瘤,具有恶性程度高、早期不易发现、易复发及转移、治疗创伤大等特点,治疗前应全面检查,明确肿瘤分期,选择合理的治疗方案,手术+术后综合治疗仍是中晚期下咽癌的主要治疗方式。
- 下咽肿瘤 /
- 癌 /
- 鳞状细胞 /
- 综合疗法 /
- 预后
Abstract: Objective:To investigate the clinical characteristics, two different treatment outcomes and prognostic factors of hypopharyngeal carcinoma.Method:The life table method was used to calculate the overall survival rates, Log-rank test was used to compare the overall survival rates between the two groups.The Cox proportional hazard model was used to perform the multivariate analysis to confirm independent treatment modalities as prognostic factors.Result:Among the 321 patients, 197 patients received surgery combine with radiotherapy or concurrent chemoradiotherapy treatment (S+R/CRT) and 124 patients received radiotherapy or concurrent chemoradiotherapy treatment (R/CRT).For 321 patients, the 1, 3, 5-year overall survival rates were 75.87%, 49.39%, 41.38% and the median survival time was 37.65 months.The difference in throat retention ratio between the radiotherapy or concurrent chemoradiotherapy treatment (41.94%) and surgery combine with radiotherapy or concurrent chemoradiotherapy treatment (11.17%) was statistically significant (P <0.01).Univariate analysis showed that clinical stage of tumor, T stage, N stage, M stage and two different treatment modalities have impact on survival prognosis.Cox regression multivariate analysis showed that T stage, N stage, two different treatment modalities were independent risk factors of prognosis.Conclusion:The overall prognosis of hypopharyngeal carcinoma was poor and dismal.Hypopharyngeal carcinoma is characterized by high degree of malignancy, difficult to be found early, prone to recurrence and metastasis after operation, large trauma and poor prognosis.Comprehensive examination should be conducted to define the stage of tumor and choose the rational treatment plan before treatment.Surgery combine with radiotherapy or chemotherapy treatment modality is still the main treatment strategy for advanced-stage hypopharyngeal carcinoma.
- hypopharyngeal neoplasms /
- carcinoma /
- squamous cell /
- combined modality therapy /
- prognosis

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