摘要
目的探讨喉癌术前放射治疗加手术的治疗方式能否比单纯手术提高治愈率。方法应用前瞻性的随机分组的方法进行临床试验。初治的喉癌病例(不包括声门型T1病变),年龄在75岁以下,不伴有喉梗阻,经过临床检查确定解剖分型、TNM分期(1978UICC)及手术类型后,通过抽签的方法将患者分入单纯手术组(SA组)或综合治疗组(RS组)进行治疗。结果共完成治疗370例,SA组215例,RS组155例。SA组3年生存率83.3%,5年生存率82.6%,10年生存率80.3%。RS组3年生存率78.9%,5年生存率76.4%,10年生存率68.6%。两组生存率差异无显著性(χ2=2.6,P=0.1)。声门上型喉癌II、IV期两组病例在5年生存率上无区别,10年生存率SA组优于RS组,10年生存率前者为73.6%,后者为63.5%,(χ2=8.3,P=0.003)。声门上型喉癌T3、T4病变行全喉切除的两组5年生存率无区别,10年生存率则差异有显著性,SA组为68%,RS组为50%(χ2=10.6,P=0.0001)。结论术前放射治疗量40Gy不能提高治愈率,而且声门上型喉癌II、IV期病变综合治疗组的10年生存率低于单纯手术组。
Objective To study the validity of preoperative radiation in improving the survial rate of laryngocarcionoma. Methods A prospective randomized clinical trial was conducted with preoperative radiation plus surgery (RS) as one group and surgery alone (SA) as the other group. The ages of the patients were less than 75 years , and the operative types were decided after clinical examination. The patients were divided into SA or RS group by random. Doses of preoperative irradiation was 40 Gy. Three hundred and seventy patients with laryngocarcinoma were treated, 215 in the SA group; 155 in the RS group. All patients were followed up over three years. Results In SA group, 3 years survival rate was 83.3%, 5 year survival rate 82.6%, 10 year survival rate 80.3%. In RS group, 3 year survival rate was 78.9%, 5 year survival rate 76.4%, 10 year survival rate 68.6%. There is no statistically significant difference in survival rates between twe groups ( P =0.1); but, the 10 year survival rate in SA group was bettter than that in RS group for the stage III and IV supraglottic carcinomas, the former was 73.6% and the latter 63.5%( P =0.003). The 10 year survival rate for the patients with T 3 and T 4 supraglottic carcinomas who underwent total laryngectomy in SA group was better than that in RS group. The former was 68% and the latter 50% ( P =0.0001). Conclusion Preoperative radiotherapy with 40 Gy didn't increase the survival rate of laryngeal carcinoma. The 10 year survival of stages III and IV supraglottic carcinoma in combined treatment group was lower than that in the surgery alone group.
出处
《中华耳鼻咽喉科杂志》
CSCD
1998年第6期364-367,共4页
Chinese Journal of Otorhinolaryngology
关键词
喉肿瘤
喉切除
放射疗法
存活率
Laryngeal neoplasms Laryngectomy Radiotherapy Survival analysis