两种颈淋巴清扫术对口腔鳞癌患者生存率和生存质量的影响

Survival Rate and Quality of Life for Patients with Oral Squamous Cell Carcinoma Treated by two Kind of Radical Neck Dissection

目的:对比分析新型改良根治性颈淋巴清扫术(modified radical neck dissection,MRND)和传统根治性颈淋巴清扫术(classical radical neck dissection,CRND)对口腔鳞癌患者生存率和生存质量的影响。方法:46例临床Ⅲ期和Ⅳ期的口腔鳞癌患者(TNM分期在T_2N_1M_0～T_4N_3M_0之间)随机分为2组:CRND组23例和MRND组23例。应用SPSS 10.0软件统计分析2组患者术后3、5年生存率,并用华盛顿大学生存质量问卷评价2组患者的生存质量。结果:①CRND组和MRND组3年生存率分别为60.7%、61.8%(P>0.05);5年生存率分别为48.6%、50.9%(P>0.05)。②CRND组和MRND组生存质量平均总分各为535.27±112.38、619.81±98.19(P<0.05)。结论:本研究采用的新型改良根治性颈淋巴清扫术与传统根治性颈淋巴清扫术相比,没有降低患者术后生存率,但显著地提高了患者术后的生存质量,适合临床推广应用。

Objective： To investigate the effects of classical radical neck dissection （CRND）and a new modified radical neck dissection （MRND） on survival rate and quality of life （QOL） of the patients with oral squamous cell carcinoma （OSCC）. Methods： 46 patients with Clinical stage Ⅲ and Ⅳ OSCC were divided randomly into two groups： group CRND （23 cases） and group MRND （23 cases）. Survival rate of 3-year and 5-year were analyzed by SPSS10.0 statistic software, UW-QOL questionnaire was used to evaluate QOL of different groups. Results： 3-year survival rate in group CRND and group MRND were 60.7% and 61.8% respectively（P〉0.05 ）, while 5-year survival rate were 48.6% and 50.9% respectively （P〉0.05）. Average total score of QOL of group CRND and group MRND were 535.27±112.38 and 619.81±98.19 respectively（P〈0.05 ）.Conclusion： MRND can improve quality of life without survival rate decrease of OSCC.