喉鳞癌62例临床分析

CLINICAL ANALYSIS OF 62 CASES OF LARYNGEAL SQUAMOUS CELL CARCINOMA

目的总结喉鳞癌不同治疗方式对患者生存率的影响,并对其预后及影响因素进行分析。方法回顾性分析1998年2月—2008年2月经病理证实的初治的喉鳞癌患者62例,采用Kaplan-Meier法和Log-rank检验进行生存分析,多因素分析采用Cox回归模型。结果 62例喉鳞癌总的5年生存率为72.6%,手术+放疗组、单纯手术组及单纯放疗组5年生存率分别为82.1%、58.2%和39.8%,三组间生存率差异有统计学意义(P<0.05),有淋巴结转移患者5年生存率为46.7%,无淋巴结转移的为71.2%,差异有统计学意义(χ2=8.96,P<0.01)。Cox多因素分析显示T分期、淋巴结转移和治疗方式是主要的预后指标。结论综合治疗是喉鳞状细胞癌的主要治疗方式,积极采取综合治疗方式可有效延长患者的生存期提高生存率。

Objective To investigate the outcome of different modes of treatment, and to analyze the prognosis of patients with laryngeal squamous cell carcinoma（LSCC）. Methods Totally 62 cases of LSCC treated from February 1998 to February 2008 were analyzed retrospectively. Survival rate was calculated by using the Kaplan- Meier method, and the comparison between groups was performed using Logrank test. Multivariate analysis was carried out using Cox regression hazard model. Results The overall five year survival rate was 72.6% ,while the rate was 82.1% in surgery plus radiotherapy group, 58.2% in surgery therapy alone group, and 39.8% in radiotherapy alone group（P〈0.05）. The 5- year survival rate of N ＋patients was lower than that of no. （X^2 = 8. 96,P〈0.01）. Cox analysis showed that T stage,lymph node metastasis and therapy modes were independent significant prognostic factors. Conclusions Combined modality therapy with radiation and surgery is the best choice of treatment in patients with laryngeal squamous cell carcinoma.