经口微创手术治疗诱导化疗后下咽癌疗效分析

Transoral minimally invasive surgery for hypopharyngeal carcinoma after induction chemotherapy efficacy analyze

目的对局部晚期下咽癌经诱导化疗降期后行微创及开放手术患者预后及喉功能保留情况分析。方法回顾性分析2016年1月~2021年12月北京同仁医院接受诱导化疗并疗效评估为大部分缓解(partial response,PR),即肿瘤靶病灶最大径之和减少≥70%后,行保留喉功能手术的54例下咽癌患者临床资料,对接受经口微创手术和颈外入路开放手术的患者术后喉功能恢复情况、生存率等进行对比分析。结果54例患者中接受经口微创手术28例,接受颈外入路部分下咽和(或)部分喉切除手术26例,两组患者术后3年生存率分别为63%和59%,差异无统计学意义(χ^(2)=0.288,P>0.05),微创手术组术后呼吸功能(χ^(2)=14.676,P<0.05)、吞咽功能(χ^(2)=10.956,P<0.05)及发声功能(χ^(2)=13.290,P<0.05)的恢复优于开放手术组,差异均有统计学意义。结论经口微创治疗在诱导化疗后降期的下咽癌患者治疗中能够获得与开放手术近似的生存率,且经口微创手术后喉功能恢复更好。

OBJECTIVE To analyse the prognosis and laryngeal function retention of patients undergoing minimally invasive and open surgery after induction chemotherapy.METHODS The clinical data of 54 hypopharyngeal carcinoma patients who received induction chemotherapy and underwent laryngeal preservation surgery in Beijing Tongren Hospital from 2016 to 2022 were retrospectively analyzed.The laryngeal function recovery and survival rate were compared between the two groups.RESULTS Twenty-eight patients underwent transoral minimally invasive surgery and 26 patients underwent partial laryngectomy and/or partial laryngectomy via external cervical approach.The 3-year survival rates of the two groups were 63%and 59%,respectively,and the difference was not statistically significant(P>0.05).The differences were statistically significant(P<0.05).CONCLUSION In patients with downstaged hypopharyngeal carcinoma after induction chemotherapy,the survival rate of transoral minimally invasive surgery is similar to that of open surgery,and the laryngeal function recovery of transoral minimally invasive surgery is better.