临床肿瘤学杂志

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92例喉癌的临床疗效分析

廖峰,秦叔逵,龚新雷,王琳,张瑜,陈映霞,刘秀峰,华海清   

  1. 解放军八一医院全军肿瘤中心内科
  • 收稿日期:2013-01-08 修回日期:2013-02-19 出版日期:2013-04-30 发布日期:2013-04-30
  • 通讯作者: 秦叔逵

Analysis of clinical efficacy in 92 patients with laryngeal carcinoma

LIAO Feng, QIN Shukui,GONG Xinlei,WANG Lin,ZHANG Yu,CHEN Yingxia,LIU Xiufeng,HUA Haiqing.   

  1. Department of Internal Medicine,Cancer Center of PLA, 81 Hospital of PLA
  • Received:2013-01-08 Revised:2013-02-19 Online:2013-04-30 Published:2013-04-30
  • Contact: QIN Shukui

摘要: 目的 探讨不同手段治疗国人喉癌患者的客观疗效、生存获益、保全喉器官功能的重要性及安全性。方法 回顾性分析2000年1月至2012年5月解放军八一医院收治的92例喉癌患者的病例资料,根据治疗方法分为放化疗组、手术组和手术联合放化疗组,分析并比较不同治疗组的治疗情况、生存时间和生存质量。结果 92例患者中,放化疗组39例,手术组20例,手术联合放化疗组33例。放化疗组中12例Ⅳ期喉癌患者分别接受过PF方案、NP/NF方案、紫杉醇为主方案化疗和中成药复方红豆杉胶囊口服,同时联合喉部放疗或西妥昔单抗治疗,获CR 1例,PR 3例,SD 6例,PD 2例,客观有效率(RR)为33.3%(4/12),疾病控制率(DCR)为83.3%(10/12);生活质量(QOL)改善7例,稳定4例,1例恶化,改善稳定率达91.6%;主要毒副反应与放化疗有关,3级恶心呕吐1例,3级白细胞减少3例,3级血小板减少1例,均未出现4级毒副反应。92例患者的中位总生存时间(OS)为60个月,放化疗组、手术组和手术联合放化疗组的中位OS分别为72、90和58个月,差异无统计学意义(P>0.05)。53例手术患者均出现明显的发音功能障碍,甚至发音功能的丧失,需永久气管切开,生活质量降低。结论 放化疗或联合分子靶向药物治疗喉癌的疗效较好,毒性可以耐受,在一定程度上可以替代手术治疗,或缩小手术范围,减低发音功能器官毁损的发生。

Abstract: Objective To investigate the objective efficacy, survival benefit, safety and the importance of preservation of the larynx organ functional in Chinese patients with laryngeal carcinoma by different means of treatment.
MethodsThe data of 92 cases of laryngeal cancer patients treated in 81 Hospital of PLA from January 2000 to May 2012 were analyzed retrospectively. All patients were divided into chemoradiotherapy group, surgical treatment group and the operation combined with chemoradiotherapy group. The treatment, survival time and the quality of life(QOL) of different treatment groups were compared and analyzed.
ResultsNinetytwo cases of laryngeal cancer patients with chemoradiotherapy group in 39 cases, 20 cases in surgical treatment group, 33 cases in the operation combined with chemoradiotherapy group. The 12 patients of stage Ⅳ in chemoradiotherapy group received PF regimen, NP/NF regimen, paclitaxelbased chemotherapy and Chinese medicine Fufang Hongdoushan capsule combined with radiotherapy of throat or cetuximab treatment. Of 12 patients in stage Ⅳ, One patient achieved CR, with PR in 3 cases, SD in 6 cases, PD in 2 cases. The response rate(RR) was 33.3%(4/12) and the disease control rate(DCR) was 83.3%(10/12). QOL was improved in 7 cases, stable in 4 cases, only 1 case of deterioration. Improvement and the stable rate was 916%. The main toxicity of chemotherapy and radiotherapy in 12 patients were grade 3 of nausea and vomiting in 1 case, grade 3 of leucopenia in 3 cases, grade 3 of thrombocytopenia in 1 case. There were no grade 4 toxicity reaction. By KaplanMeier method, the median overall survival time of 92 patients with laryngeal carcinoma was 60 months. The median overall survival time was 72 months in the chemoradiotherapy group, 90 months in the surgical treatment group and 58 months in the operation combined with chemoradiotherapy group. There were no statistical differences among the three groups(P>0.05). Fiftythree of operation patients had obvious pronunciation dysfunction, even lost the pronunciation function, needed permanent tracheostomy and quality of life was reduced. Conclusion Chemotherapy or combined with molecular targeted drugs in the treatment of laryngeal cancer has a good efficacy and toxicity can be tolerated. For a considerable part of the patients, it can replace operation, or reduce the scope of operation and the damage.

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