杜镭, 马林, 冯林春, 曲宝林, 王发鹏, 曾铭玥, 杨微. 107例晚期喉癌患者放疗疗效分析[J]. 解放军医学院学报, 2015, 36(9): 916-919. DOI: 10.3969/j.issn.2095-5227.2015.09.016
引用本文: 杜镭, 马林, 冯林春, 曲宝林, 王发鹏, 曾铭玥, 杨微. 107例晚期喉癌患者放疗疗效分析[J]. 解放军医学院学报, 2015, 36(9): 916-919. DOI: 10.3969/j.issn.2095-5227.2015.09.016
DU Lei, MA Lin, FENG Linchun, QU Baolin, WANG Fapeng, ZENG Mingyue, YANG Wei. Locally advanced laryngeal cancer treated by radiotherapy: A survival analysis of 107 cases[J]. ACADEMIC JOURNAL OF CHINESE PLA MEDICAL SCHOOL, 2015, 36(9): 916-919. DOI: 10.3969/j.issn.2095-5227.2015.09.016
Citation: DU Lei, MA Lin, FENG Linchun, QU Baolin, WANG Fapeng, ZENG Mingyue, YANG Wei. Locally advanced laryngeal cancer treated by radiotherapy: A survival analysis of 107 cases[J]. ACADEMIC JOURNAL OF CHINESE PLA MEDICAL SCHOOL, 2015, 36(9): 916-919. DOI: 10.3969/j.issn.2095-5227.2015.09.016

107例晚期喉癌患者放疗疗效分析

Locally advanced laryngeal cancer treated by radiotherapy: A survival analysis of 107 cases

  • 摘要: 目的 回顾性分析解放军总医院107例局部晚期喉癌患者放疗疗效及影响因素。 方法 2007年5月-2013年4月解放军总医院收治经放疗的107例晚期喉癌患者,放疗采取三维适形放疗(35.5%)或适形调强放疗(64.5%),高危淋巴引流区处方剂量50 ~ 60 Gy,低危计划靶区处方剂量44 ~ 54 Gy;17例未行手术及10例手术不彻底患者接受根治性放疗,残余病灶或转移淋巴结处方剂量64.5 ~ 70 Gy。根据RTOG/EORTC 标准评价急性反应。 结果 中位随访31.8个月,放疗相关急性反应主要为皮肤反应、口腔黏膜炎及咽食管炎,发生率分别为99.1%、84.1%、77.6%。全组病例中32例治疗失败,26例死亡。死亡病例中23例死于肿瘤相关因素,3例死于非肿瘤因素;3年无局部复发生存率、无区域复发生存率、无远处转移生存率及总生存率分别为78.5%、95.2%、88.9%、75.7%。进行单因素分析后发现临床分期影响3 年无局部复发生存率,原发部位影响3 年无远处转移生存率,手术术式对生存率无显著影响。 结论 对于无法行手术切除或有强烈保喉意愿的患者,根治性放化疗可取得较好效果,手术则可作为该治疗方法局部失败后有效的挽救方式。

     

    Abstract: Objective To analyze the clinical results of 107 patients with locally advanced laryngeal cancer treated by radiotherapy n Chinese PLA General Hospital. Methods One hundred and seven newly diagnosed laryngeal cancer patients of stage Ⅲ or Ⅳ were treated with radiotherapy from May 2007 to April 2013. Three-dimensional conformal radiotherapy(3DCRT) (35.5%) and ntensity modulated radiation therapy (IMRT)(64.5%) were used in the study. The prescription dose was 50-60 Gy to the high risk arget and 44-54 Gy to the low risk target. Seventeen cases with no surgery and 10 cases of incomplete resection underwent radical adiotherapy. The prescription dose of residual tumor or metastatic lymph node target region was 64.5-70 Gy. Acute side-effects were valuated following the established RTOG/EORTC criteria. Results The median follow up time was 31.8 months (range, 4 to 76 months). The incidence rate of skin toxicity, oral mucositis and esophagitis - tracheitis was 99.1%, 84.1% and 77.6%, respectively. Until May 2014, there were 32 cases had treatment failure and 26 cases died. Of all the died patients, 23 died of tumor-related factors nd 3 died of other factors. The local relapse-free survival (LRFS), regional relapse-free survival (RRFS), distant metastasis-free urvival (MFS) and overall survival (OS) were 78.5%, 95.2%, 88.9% and 75.7% for 3 years. The clinical stage was an independent actor for the 3-year LRFS and tumor location could affect 3-year MFS, while the different surgical methods did not show infuences on the survival. Conclusion Radical chemoradiotherapy is a good choice for patients unft for surgery or be willing to reserving aryngeal function and salvage surgery is effective for the failure cases.

     

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