160例扁桃体癌的放射治疗及预后

Radiotherapy and prognosis of 160 patients with tonsillar carcinoma

目的 回顾性分析放射治疗扁桃体癌的疗效及预后因素。方法 16 0例经病理证实的扁桃体癌均行单纯根治性放射治疗。根据 1997年国际抗癌联盟分期标准 ,Ⅰ期 7例 ,Ⅱ期 2 9例 ,Ⅲ期43例 ,Ⅳ期 81例。生存分析采用Kaplan Meier法及Logrank检验 ,多因素分析采用Cox回归模型。结果 全组 5、10年总生存率分别为 5 9.2 %、5 2 .1% ,5、10年无瘤生存率分别为 5 9.0 %、5 6 .3%。Ⅰ～Ⅳ期 5年生存率分别为 83.3%、83.7%、73.5 %和 40 .7%。多因素分析显示T、N分期为主要的预后因素。结论 单纯放射治疗扁桃体癌特别是对Ⅰ、Ⅱ期病变可取得较好的疗效 ,T。

Objective To evaluate the therapeutic outcome and define the prognostic factors in patients with tonsillar carcinoma after radical radiotherapy. Methods From April 1958 to May 1998, 160 patients with tonsillar carcinoma proven pathology, treated primarily with definitive radiotherapy were eligible for the present analysis. According to TNM staging system, there are 7 Stage Ⅰ, 29 Stage Ⅱ, 43 Stage Ⅲ and 81 Stage Ⅳ patients. The significance of prognostic variables in the survival expectancy was evaluated with multivariate analysis and Cox stepwise regression model. Results The 5 , 10 year actuarial survival rates were 59.2% and 52.1%.The 5 ,10 year disease free survival rates were 59.0% and 56.3%, respectively. The 5 year survival rates based on stage were 83.3% for Stage Ⅰ, 83.7% for Stage Ⅱ, 73.5% for Stage Ⅲ and 40.7% for Stage Ⅳ , respectively (P = 0.002). Multivariate analysis showed that T and N stages are the significant prognostic factors (P<0.05). Conclusions Radiotherapy for tonsillar carcinoma is a primary treatment for the selection, especially for Stage Ⅰ and Ⅱ patients who are likely to give good results. The primary tumor and neck stages are the signifcant prognostic factors.