射频消融术联合化疗与手术联合化疗治疗声门型喉癌的效果对比
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摘要
目的比较射频消融术(RFA)联合化疗与手术联合化疗治疗声门型喉癌的临床效果。方法选择2013年12月~2014年12月武警陕西总队医院收治的声门型喉癌患者92例,采用简单随机法将患者分为对照组与观察组,每组各46例。对照组患者给予手术联合化疗治疗,观察组患者给予RFA联合化疗。对治疗后两组患者的临床疗效、生活质量KPS评分、不良反应发生率、肿瘤细胞凋亡率、术后复发情况及存活率进行比较。结果治疗后,观察组临床治疗有效率及临床症状控制率均高于对照组,两组比较差异有统计学意义(P<0.05);观察组患者的生活质量KPS评分明显高于治疗前和对照组,差异有统计学意义(P<0.05);观察组Ⅲ级及Ⅳ级不良反应的发生率均低于对照组,两组比较差异有统计学意义(P<0.05);观察组肿瘤细胞凋亡率高于对照组,两组比较差异有统计学意义(P<0.05)。两组复发率及存活率比较,差异均无统计学意义(P>0.05)。结论对声门型喉癌患者进行RFA联合化疗治疗,可明显提高临床疗效、生活质量及肿瘤细胞凋亡率,减少不良反应,值得临床推广与应用。
Objective To compare clinical efficacy of radiofrequency ablation combined with chemotherapy and surgery combined with chemotherapy in the treatment of glottic carcinoma. Methods Totally 92 patients with glottic carcinoma in Shaanxi General Hospital of CAPF from December 2013 to December 2014 were randomly divided into observation group and control group by simple random method, with 46 cases in each group. Control group was treated by surgery combined with chemotherapy, while observation group was treated by radiofrequency ablation combined with chemotherapy. Clinical efficacy, KPS scores, the incidence of adverse reaction, apoptosis rate, recurrence rate and the survival rate of patients in the two groups were compared. Results After the treatment, clinical efficacy of patients in the observation group after treatment was significantly higher than that in the control group, the difference was statistically significant(P < 0.05). KPS scores of patients in observation group after treatment was significantly higher than that of the control group, the difference was statistically significant(P < 0.05). The incidence of level 3 and 4 adverse reaction of patients in observation group after treatment was significantly lower than that of the control group, the difference was statistically significant(P < 0.05). The apoptosis rate of patients in observation group after treatment was significantly higher than that in control group, the difference was statistically significant(P < 0.05). The recurrence rate and the survival rate were no significant difference between two groups(P > 0.05). Conclusion Radiofrequency ablation combined with chemotherapy in treatment of glottic carcinoma can enhance clinical efficacy, life quality and the apoptosis rate, and reduce the incidence of adverse reaction. It is worthy of clinical application.
Objective To compare clinical efficacy of radiofrequency ablation combined with chemotherapy and surgery combined with chemotherapy in the treatment of glottic carcinoma. Methods Totally 92 patients with glottic carcinoma in Shaanxi General Hospital of CAPF from December 2013 to December 2014 were randomly divided into observation group and control group by simple random method, with 46 cases in each group. Control group was treated by surgery combined with chemotherapy, while observation group was treated by radiofrequency ablation combined with chemotherapy. Clinical efficacy, KPS scores, the incidence of adverse reaction, apoptosis rate, recurrence rate and the survival rate of patients in the two groups were compared. Results After the treatment, clinical efficacy of patients in the observation group after treatment was significantly higher than that in the control group, the difference was statistically significant(P < 0.05). KPS scores of patients in observation group after treatment was significantly higher than that of the control group, the difference was statistically significant(P < 0.05). The incidence of level 3 and 4 adverse reaction of patients in observation group after treatment was significantly lower than that of the control group, the difference was statistically significant(P < 0.05). The apoptosis rate of patients in observation group after treatment was significantly higher than that in control group, the difference was statistically significant(P < 0.05). The recurrence rate and the survival rate were no significant difference between two groups(P > 0.05). Conclusion Radiofrequency ablation combined with chemotherapy in treatment of glottic carcinoma can enhance clinical efficacy, life quality and the apoptosis rate, and reduce the incidence of adverse reaction. It is worthy of clinical application.
引文
[1]李言冰,蔡晓军,冯稢妮,等.早期声门型喉癌治疗进展[J].中国激光医学杂志,2013,22(5):389-393.
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[3]尹显祥,张裙,张园园.早期声门型喉癌治疗的预后分析[J].中国耳鼻咽喉头颈外科,2013,20(4):193-195.
[4]王蓓蕾,徐立红,袁晖,等.喉癌相关基因的研究进展[J].中国细胞生物学学报,2014,36(9):1323-1330.
[5]张玉玲,谷京城.喉癌术后生存率相关因素的研究进展[J].临床耳鼻咽喉头颈外科杂志,2010,24(4):189-192.
[6]汤玮晶,陶磊.喉癌患者术后生存质量的研究进展[J].中国眼耳鼻喉科杂志,2014,14(2):124-126.
[7]赵卫民,黄武,廖兰芳,等.显微喉镜下等离子射频手术治疗早期声门型喉癌33例临床分析[J].广西医科大学学报,2014,31(4):690-691.
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[9]刘剑勇,陆建斌,袁毅方,等.累及前联合或双侧声带的声门型喉癌患者的手术方法探讨[J].实用癌症杂志,2014,29(9):1177-1179.
[10]赵春红,李玉杰,于敏,等.CO2激光与等离子射频消融术治疗早期声门型喉癌疗效比较[J].听力学及言语疾病杂志,2015,22(3):307-309.
[11]梁葳,章海波,黄壮荣,等.顺铂联合去甲斑螯酸纳对非小细胞癌的免疫功能及预后分析[J].转化医学电子杂志,2015,2(11):43-45.
[12]李言冰,蔡晓军,李黎波.小剂量顺铂化疗对早期声门型喉癌治疗的影响[J].中国生化药物杂志,2014,3(34):93-97.
[13]Georgescu C,Margaritescu C,Osman I,et al.Therapeutic management of massive subcutaneous emphysema,bilateral pneumothorax and pneumomediastinum after anterior cordectomy for in situ vocal cord carcinoma-case report[J].Chirurgia(Bucur),2014,109(6):822-826.
[14]Reiter R,Brosch S,Smith E,et al.Management of T1a vocal fold carcinoma[J].Laxyngo-rhino-otologie,2013,92(12):797-807.
[15]杨丹.早期声门型喉癌中血管、淋巴管生成特点及临床意义[D].衡阳:南华大学,2014.
[16]陈嘉.两种修复方式在喉癌喉部分切除术后喉功能重建中的应用[D].泸州:泸州医学院,2014.
[17]张庆丰,刘得龙,宋伟,等.等离子射频消融术治疗早期声门型喉癌的疗效观察[J].临床耳鼻咽喉头颈外科杂志,2011,25(18):855-856.
[18]张庆丰,刘得龙,张悦,等.等离子射频治疗早期声门型喉癌的初步研究[J].中华耳鼻咽喉头颈外科杂志,2011,46(1):63-65.
[19]尹中普.射频消融术联合化疗在声门型喉癌治疗中的临床观察[J].中国医学创新,2013,10(22):16-17.
[20]Aaltonen LM,Rautiainen N,Sellman J,et al.Voice quality after treatment of early vocal cord cancer:a random ized trial comparing laser surgery with radiation therapy[J].Int J Radiat Oncol Biol Phys,2014,90(2):255-260.
[2]代冕,胡国华.早期声门型喉癌的放疗及同步放化疗的研究进展[J].医学综述,2013,19(22):4090-4092.
[3]尹显祥,张裙,张园园.早期声门型喉癌治疗的预后分析[J].中国耳鼻咽喉头颈外科,2013,20(4):193-195.
[4]王蓓蕾,徐立红,袁晖,等.喉癌相关基因的研究进展[J].中国细胞生物学学报,2014,36(9):1323-1330.
[5]张玉玲,谷京城.喉癌术后生存率相关因素的研究进展[J].临床耳鼻咽喉头颈外科杂志,2010,24(4):189-192.
[6]汤玮晶,陶磊.喉癌患者术后生存质量的研究进展[J].中国眼耳鼻喉科杂志,2014,14(2):124-126.
[7]赵卫民,黄武,廖兰芳,等.显微喉镜下等离子射频手术治疗早期声门型喉癌33例临床分析[J].广西医科大学学报,2014,31(4):690-691.
[8]李玉杰,于敏,赵春红,等.CO2激光联合等离子射频消融术治疗早期声门型喉癌临床观察[J].中国耳鼻咽喉颅底外科杂志,2014,20(4):345-347.
[9]刘剑勇,陆建斌,袁毅方,等.累及前联合或双侧声带的声门型喉癌患者的手术方法探讨[J].实用癌症杂志,2014,29(9):1177-1179.
[10]赵春红,李玉杰,于敏,等.CO2激光与等离子射频消融术治疗早期声门型喉癌疗效比较[J].听力学及言语疾病杂志,2015,22(3):307-309.
[11]梁葳,章海波,黄壮荣,等.顺铂联合去甲斑螯酸纳对非小细胞癌的免疫功能及预后分析[J].转化医学电子杂志,2015,2(11):43-45.
[12]李言冰,蔡晓军,李黎波.小剂量顺铂化疗对早期声门型喉癌治疗的影响[J].中国生化药物杂志,2014,3(34):93-97.
[13]Georgescu C,Margaritescu C,Osman I,et al.Therapeutic management of massive subcutaneous emphysema,bilateral pneumothorax and pneumomediastinum after anterior cordectomy for in situ vocal cord carcinoma-case report[J].Chirurgia(Bucur),2014,109(6):822-826.
[14]Reiter R,Brosch S,Smith E,et al.Management of T1a vocal fold carcinoma[J].Laxyngo-rhino-otologie,2013,92(12):797-807.
[15]杨丹.早期声门型喉癌中血管、淋巴管生成特点及临床意义[D].衡阳:南华大学,2014.
[16]陈嘉.两种修复方式在喉癌喉部分切除术后喉功能重建中的应用[D].泸州:泸州医学院,2014.
[17]张庆丰,刘得龙,宋伟,等.等离子射频消融术治疗早期声门型喉癌的疗效观察[J].临床耳鼻咽喉头颈外科杂志,2011,25(18):855-856.
[18]张庆丰,刘得龙,张悦,等.等离子射频治疗早期声门型喉癌的初步研究[J].中华耳鼻咽喉头颈外科杂志,2011,46(1):63-65.
[19]尹中普.射频消融术联合化疗在声门型喉癌治疗中的临床观察[J].中国医学创新,2013,10(22):16-17.
[20]Aaltonen LM,Rautiainen N,Sellman J,et al.Voice quality after treatment of early vocal cord cancer:a random ized trial comparing laser surgery with radiation therapy[J].Int J Radiat Oncol Biol Phys,2014,90(2):255-260.