59例晚期声门上型喉鳞状细胞癌治疗和临床疗效分析

The treatment and clinical therapeutic effect analysis in 59cases of advanced supraglottic laryngeal squamous cell carcinoma

目的:比较手术加辅助放疗与单纯手术治疗晚期声门上型喉鳞状细胞癌的疗效。方法:将59例晚期声门上型喉鳞状细胞癌按治疗方法分为手术+放疗组(33例)和手术组(26例)。手术+放疗组全喉切除27例,部分切除6例,其中27例行侧颈淋巴结清扫术;手术组全喉切除23例,部分切除3例,其中24例行侧颈淋巴结清扫术。结果:手术+放疗组和手术组的3年总生存率分别为62.6%和62.6%,5年总生存率分别为43.8%和40.5%,经Log-rank检验两组之间的生存率差异无统计学意义(P>0.05)。手术+放疗组5例复发,复发率15.2%;手术组10例复发,复发率38.5%,两组的复发率差异有统计学意义(P<0.05)。结论:手术加辅助放疗未能提高晚期声门上型喉鳞状细胞癌3、5年总生存率,但明显降低肿瘤复发率。

To compare the therapeutic effect of postoperative radiotherapy with surgery alone in ad- vanced supraglottic laryngeal squamous cell carcinoma（LSCC）. Method： According to the treatment methods, 59 patients with advanced supraglottic LSCC were divided into surgery plus radiotherapy group（S＋R group） （33 ca- ses） and surgical group（S group）（26 cases）. In S^-R group, total laryngectomy was performed on 27 patients and partial laryngectomy on 6 patients, 27 of whom underwent lateral neck dissections; while in S group, total laryn- geetomy was performed on 23 patients and partial laryngectomy on 3 patients, 24 of whom underwent lateral neck dissections. Result：The 3-year overall survival rate of S＋R and S group were 62.6% and 62.6% respectively, and the 5-year overall survival rate of S＋R and S group were 43.8% and 40.5% respectively. But there was no statistically significant difference of survival rate between two groups by Log-rank test（P〈0.05）. In S＋R group, re- currence happend in 5 cases and the recurrent rate was 15.1%; in S group, recurrence happend in 10 patients and the recurrent rate was 38. 5%, statistically significant difference was found between the two recurrent rates （P〈0.05）. Conclusion：Surgery combined with postoperative radiotherapy could not improve the 3-year-or 5-year overall survival rate, but could significantly reduced tumor recurrence rate.