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目的:评价晚期喉咽癌术后辅助综合治疗的疗效,探讨提高喉咽癌患者生活质量及生存率的方法。方法:76例男性Ⅲ～IV期喉咽癌患者接受术后辅助治疗,其中44例进行术后单纯放疗,32例接受术后同步放化疗。结果:通过Kaplan-Meier法进行生存分析,其中术后单纯放疗组患者5年总生存率为25.9%,术后同步放化疗组为27.8%,两组比较差异无统计学意义(P>0.05)。术后单纯放疗组3年和5年的肿瘤无复发生存率分别为36.0%和22.5%,而术后同步放化疗组分别为68.0%和45.3%,两组比较差异有统计学意义(P<0.05)。按照NCI.CTC3.0版标准评价,两组的毒性反应主要有疲乏、白细胞减少、血小板下降、局部皮肤发红脱屑、脱发等,C3/4级的毒副反应共有14例,其中9例肺部感染,2例为放射性头痛,3例为白细胞及血小板下降。术后单纯放疗组及术后同步放化疗组的C3/4级毒副反应分别为6例和8例,两组间比较,差异无统计学意义(P>0.05)。结论:对于晚期喉咽癌,术后同步放化疗相比于术后单纯放疗可以提高患者无复发生存率,改善生活质量,同时并没有增加患者治疗的毒副反应。
Objective: To evaluate the efficacy of postoperative adjuvant chemotherapy for advanced hypopharyngeal carcinoma and to explore ways to improve the quality of life and survival of patients with hypopharyngeal carcinoma. Methods: Seventy - six patients with stage Ⅲ ~ Ⅳ hypopharyngeal carcinoma underwent postoperative adjuvant therapy. Among them, 44 patients underwent postoperative radiotherapy alone and 32 patients received concurrent chemoradiotherapy after operation. Results: Survival analysis by Kaplan-Meier method showed that the postoperative 5-year overall survival rate was 25.9% in radiotherapy alone group and 27.8% in concurrent chemoradiotherapy group. There was no significant difference between the two groups (P> 0.05) . The 3-year and 5-year rates of recurrence-free survival were 36.0% and 22.5% in the radiotherapy alone group compared with 68.0% and 45.3% in the concurrent chemoradiation group, respectively, with significant difference between the two groups (P < 0.05). According to NCI.CTC3.0 version of the standard assessment, the two groups of toxicity mainly fatigue, leukopenia, thrombocytopenia, local skin redness desquamation, hair loss, C3 / 4 grade toxicity in a total of 14 cases, of which 9 cases Pulmonary infection, 2 cases of radioactive headache, 3 cases of leukopenia and thrombocytopenia. There were 6 cases and 8 cases of grade C3 / 4 toxicity after radiotherapy alone and postoperative concurrent radiotherapy and chemotherapy respectively. There was no significant difference between the two groups (P> 0.05). Conclusions: For late-stage hypopharyngeal carcinoma, postoperative concurrent chemoradiotherapy can improve recurrence-free survival and quality of life compared with postoperative radiotherapy without increasing the side effects of treatment.