手术与手术联合放化疗对70例喉癌患者的临床效果比较
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摘要
目的分析研究经手术与手术联合放化疗治疗70例喉癌患者中的临床效果比较及远期并发症。方法选取喉癌患者70例,随机分成对照组和观察组2组,各35例,对照组仅行手术切除,试验组行手术+放化疗治疗,分析比较2组的临床效果及远期并发症情况。结果观察组35例喉癌患者中Ⅰ、Ⅱ、Ⅲ、Ⅳ期患者术后5年生存率分别为90.91%、61.54%、44.44%、0,与对照组(83.33%、58.33%、44.44%、0)相比无显著性差异,临床总有效率远远高于对照组,差异具有统计学意义(P<0.05),且观察组5年总生存率(60.00%)与对照组(62.86%)较接近,P>0.05。观察组复发转移总发生率为34.28%,与对照组(37.14%)相比无统计学差异,P>0.05。观察组术后2例喉腔狭窄、3例肺部感染、3切口感染、2例皮下气肿、1例第二原发恶性肿瘤(食管癌),对照组术后2例喉腔狭窄、4例肺部感染、2切口感染、3例皮下气肿、2例第二原发恶性肿瘤(食管癌),两组对比无统计学差异,P>0.05。观察组术后的总满意度(74.28%)与对照组(77.14%)接近,不存在统计学差异(P>0.05)。结论针对于喉癌患者,采用手术疗法与手术联合放化疗治疗的术后生存率、复发转移情况无明显差异,两种方式的并发症并无显著不同,但针对不同患者可采取相应放化疗进行延缓病情发展,本研究对临床上研究喉癌治疗具有参考价值。
Objective To evaluate the clinical efficacy and long-term complications of 70 patients with laryngeal carcinoma treated by surgery and surgery combined with radiotherapy and chemotherapy.Methods 60 patients with laryngeal cancer were randomly divided into the control group and the observation group(n = 35).The control group was treated with surgical resection.The patients were treated with chemotherapy and chemotherapy.The clinical effects and long-term complications were analyzed.Results The 5-year survival rates of patients with stage Ⅰ,Ⅱ,Ⅲ and Ⅳ laryngeal cancer were 90.91%,61.54% and44.44%,0% respectively,and of the control group were 83.33%,58.33%,44.44%,0%(P < 0.05),and the 5-year overall survival rate of the observation group(60.00%) and that of the control group(62.86%) was similar(P > 0.05),the total recurrence rate of the observation group was 34.28%,which was not statistically different from that of the control group,37.14%(P >0.05).In the observation group,there had 2 cases of laryngeal stenosis,3 cases of pulmonary infection,3 cases of incision infection,2 cases of subcutaneous emphysema,1 case of primary malignant tumor(esophageal cancer),in the control group,there had2 cases of laryngeal stenosis,4 cases of lung Department of infection,2 cases of incision infection,3 cases of subcutaneous emphysema,2 cases of second primary malignant tumor(esophageal cancer),the 2 groups had no significant difference,P > 0.05.The total satisfaction(74.28%) in the observation group was close to that of the control group(77.14%),and there was no statistical difference(P > 0.05).Conclusion There has no significant difference in the survival rate and recurrence between operation and operation combined with radiotherapy and chemotherapy for laryngeal cancer.There has no significant difference in complications between the 2 methods,but the corresponding radiotherapy and chemotherapy delay the development of the disease,the study of laryngeal cancer has a reference value.
Objective To evaluate the clinical efficacy and long-term complications of 70 patients with laryngeal carcinoma treated by surgery and surgery combined with radiotherapy and chemotherapy.Methods 60 patients with laryngeal cancer were randomly divided into the control group and the observation group(n = 35).The control group was treated with surgical resection.The patients were treated with chemotherapy and chemotherapy.The clinical effects and long-term complications were analyzed.Results The 5-year survival rates of patients with stage Ⅰ,Ⅱ,Ⅲ and Ⅳ laryngeal cancer were 90.91%,61.54% and44.44%,0% respectively,and of the control group were 83.33%,58.33%,44.44%,0%(P < 0.05),and the 5-year overall survival rate of the observation group(60.00%) and that of the control group(62.86%) was similar(P > 0.05),the total recurrence rate of the observation group was 34.28%,which was not statistically different from that of the control group,37.14%(P >0.05).In the observation group,there had 2 cases of laryngeal stenosis,3 cases of pulmonary infection,3 cases of incision infection,2 cases of subcutaneous emphysema,1 case of primary malignant tumor(esophageal cancer),in the control group,there had2 cases of laryngeal stenosis,4 cases of lung Department of infection,2 cases of incision infection,3 cases of subcutaneous emphysema,2 cases of second primary malignant tumor(esophageal cancer),the 2 groups had no significant difference,P > 0.05.The total satisfaction(74.28%) in the observation group was close to that of the control group(77.14%),and there was no statistical difference(P > 0.05).Conclusion There has no significant difference in the survival rate and recurrence between operation and operation combined with radiotherapy and chemotherapy for laryngeal cancer.There has no significant difference in complications between the 2 methods,but the corresponding radiotherapy and chemotherapy delay the development of the disease,the study of laryngeal cancer has a reference value.
引文
[1]李文,史丽英,杨柳,等.T3期声门型喉癌CO_2激光与喉裂开术的初步研究[J].华西医学,2013,28(1):61-63.
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[5]张赫佳.姜黄素对喉癌Hep-2细胞的化疗增敏作用及机制研究[D].吉林大学,2014.
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[7]徐华,张海萍,李乐.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[J].中国医药导报,2016,13(20):100-102.
[8]吕茵.~(18)F-FDG PET/CT显像在喉癌诊断和术后复发、转移监测中的应用[D].南方医科大学,2013.
[9]鲁光平,潘骥群,刘志标.DCF方案诱导化疗后手术治疗喉癌及下咽癌T_(2-3)病变疗效分析[J].临床耳鼻咽喉头颈外科杂志,2015,29(7):585-588.
[10]汤晨,王成师,刘收厚,等.手术、放疗和光动力治疗分别联合小剂量化疗治疗早期声门型喉癌的疗效对比[J].现代肿瘤医学,2015,26(24):3580-3582.
[11]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,2014,34(3):93-97.
[12]赵永强.塞来昔布诱导喉癌Hep-2细胞凋亡及细胞周期阻滞的实验研究[D].山东大学,2014.
[13]谢芳.236例喉癌患者手术治疗生存效果分析[D].上海交通大学,2014.
[14]司勇锋,陶仲强,张政等.手术联合同步放化疗治疗早期鼻咽癌的前瞻性研究[J].临床耳鼻咽喉头颈外科杂志,2012,26(9):422-425.
[2]黎长江,王胜资,丁浩,等.喉癌切缘状况与术后放疗和联合化疗预后相关性分析[J].中华肿瘤防治杂志,2013,20(2):137-140.
[3]廖峰,秦叔逵,龚新雷,等.92例喉癌的临床疗效分析[J].临床肿瘤学杂志,2013,18(4):340-343.
[4]刘珂,钱立庭,高劲.手术联合放疗治疗喉癌的疗效及预后因素分析[J].临床肿瘤学杂志,2013,18(10):910-913.
[5]张赫佳.姜黄素对喉癌Hep-2细胞的化疗增敏作用及机制研究[D].吉林大学,2014.
[6]陈杰,黄文孝,周晓,等.晚期喉癌下咽癌术后缺损的修复[J].中国耳鼻咽喉颅底外科杂志,2016,22(2):120-124.
[7]徐华,张海萍,李乐.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[J].中国医药导报,2016,13(20):100-102.
[8]吕茵.~(18)F-FDG PET/CT显像在喉癌诊断和术后复发、转移监测中的应用[D].南方医科大学,2013.
[9]鲁光平,潘骥群,刘志标.DCF方案诱导化疗后手术治疗喉癌及下咽癌T_(2-3)病变疗效分析[J].临床耳鼻咽喉头颈外科杂志,2015,29(7):585-588.
[10]汤晨,王成师,刘收厚,等.手术、放疗和光动力治疗分别联合小剂量化疗治疗早期声门型喉癌的疗效对比[J].现代肿瘤医学,2015,26(24):3580-3582.
[11]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,2014,34(3):93-97.
[12]赵永强.塞来昔布诱导喉癌Hep-2细胞凋亡及细胞周期阻滞的实验研究[D].山东大学,2014.
[13]谢芳.236例喉癌患者手术治疗生存效果分析[D].上海交通大学,2014.
[14]司勇锋,陶仲强,张政等.手术联合同步放化疗治疗早期鼻咽癌的前瞻性研究[J].临床耳鼻咽喉头颈外科杂志,2012,26(9):422-425.