晚期喉咽癌术后同步放化疗与术后单纯放疗疗效比较

摘要

目的：比较晚期喉咽癌术后同步放化疗与术后单纯放疗的疗效。方法：72例晚期喉咽癌患者手术后接受单纯放疗37例(放疗组),其中保留喉功能(保喉)手术者20例,非保喉手术者17例；手术后进行同步放疗与化疗35例(同步放化疗组),其中保喉手术者24例,非保喉手术者11例。比较2组生存率和生活质量,同时比较保喉者(44例)与非保喉者(28例)生存率。结果：放疗组患者3年生存率48.65%,5年生存率24.32%；同步放化疗组患者3年生存率71.43%,5年生存率48.57%,2组患者3年和5年生存率差异均有统计学意义(P0.05)；2组患者咽瘘发生率以及吞咽、语言功能恢复情况差异均无统计学意义(P>0.05)。保喉者3年生存率40.90%,5年生存率27.27%,非保喉者3年生存率60.71%,5年生存率39.28%,2组患者3年和5年生存率差异均无统计学意义(P>0.05)。结论：晚期喉咽癌患者术后进行同步放化疗比术后单纯放疗3年及5年生存率高,且不增加不良反应,不影响患者术后生活质量；保喉手术与非保喉手术3年和5年生存率均无明显不同,可根据患者情况尽量保留喉功能。%Objective:To explore the clinical effects of postoperative chemoradiation and radiotherapy on advanced hypopharyngeal carcinoma. Methods:Thirty-seven patients with advanced hypopharyngeal carcinoma( including 20 cases with laryngeal function and 17 cases without laryngeal function ) were treated with radiotherapy after surgery ( radiotherapy group ) , 35 patients with advanced hypopharyngeal carcinoma ( including 24 cases with laryngeal function and 11 cases without laryngeal function ) were treated with chemoradiation after surgery(chemoradiation group). The survival rate and life quality of two groups were compared,and the survival rate of patients with and without laryngeal function was compared. Results:The 3-year and 5-year survival rates in radiotherapy group and chemoradiation group were 48. 65% & 71. 43% and 24. 32% & 48. 57%,respectively,the difference of which was statistically significant(P0. 05). The 3-year and 5-year survival rates in patients with and without without laryngeal function were 40. 90% &60. 71% and 27. 27% &39. 28%,respectively,the difference of which was not statistically significant(P>0. 05). Conclusions:The survival rates of 3- and 5-year of patients with advanced hypopharyngeal carcinoma treated with chemoradiation are higher than those of patients treated only with radiotherapy,the treatment does not increase the toxicity and affect the life quality of postoperative patients. The survival rates of 3-and 5-year of patients with and without laryngeal function are similar,and the laryngeal function can be preserved according to the disease.