腭扁桃体鳞癌远期疗效回顾性分析

Retrospective analysis of the curative result of palatina tonsillar carcinoma:Report of 186 cases

目的 :回顾分析单纯放疗、单纯手术及综合治疗腭扁桃体鳞癌的远期疗效。方法 :资料完整的 186例患者 , 期 77例 , 期 2 3例 , 期 82例 , 期 4例。应用单纯放疗 50例 ,单纯手术 31例 ,术前放疗 52例 ,术后放疗 53例。结果 :186例总 5年存活率为 54.8% (10 2 / 186 )。各期分别为 期 6 3.6 % , 期 56 .5% , 期 4 8.8% , 期 0 .0 %。 58例死于肿瘤局部复发。合并颈淋巴结转移者 5年存活率为4 7.6 2 % (4 0 / 84 ) ,侵犯扁桃体周围组织者为 4 7.9% (34/ 71)。结论 :腭扁桃体鳞癌的治疗以综合治疗较单纯放疗和单纯手术效果好 ,选择术前或术后放疗方式对存活率无明显影响。有效地控制肿瘤局部复发是提高腭扁桃体鳞癌 5年存活率的关键。

Objective:To study the late curative result of different managements applied in treatment of paratina tonsillar squamous cell carcinoma.Methods:The late curative result of 186 patients with paratina tonsillar squamous cell carcinoma were analysed.There were 108 males and 78 females,ranging in age from 19 to 79 years old.Among 186 cases,77 cases were in stage Ⅰ,23 in stage Ⅱ,82 in stage Ⅲ,4 in stage Ⅳ;50 patients were treated by irradiation alone,31 by surgery alone,52 by preoperative radiotherapy and 53 by postoperative radiotherapy.Results:The overall 5 year survival rates of 186 patients were 54.8% (102/186);and the survival rates were 63.6% (49/77),56.5% (13/23),48.8% (40/82) and 0.0%(0/4) in stage Ⅰ,Ⅱ,Ⅲ and Ⅳ respectively.Fifty eight patients died of local recurrence.The 5 year survival rates were 47.62% (40/84) and 47.9% (34/71) in patients with lymph metastasis and cancer involving peritonsillar tissue respectively.Conclusion:The late curative result was better in combination of surgery and radiotherapy.There were no significant difference in the survival rates between preoperative and postoperative radiotherapy groups.The key to the successful treatment for tonsillar carcinoma was the control of local recurrence of the cancer.