下咽癌的治疗

Treatment for hypopharyngeal carcinoma

目的 总结中国医学科学院肿瘤医院 30余年下咽癌治疗的经验。方法 初程以根治性治疗为目的收治的下咽癌病例 2 6 2例 ,术前放射治疗加手术 14 6例 (5 5 .7% ) ,单纯放射治疗 80例(30 .5 % ) ,手术加术后放射治疗 17例 (6 .5 % ) ,单纯手术治疗 19例 (7.3% )。全组分为 6 0～ 70年代、80年代和 90年代 3个治疗时期 ,分析各时期病例的特点、治疗方法、放射治疗技术和预后。结果 随着治疗方法和技术的改进 ,5年总生存率和无瘤生存率分别由 6 0～ 70年代的 14 .3%和 2 3.8%提高到 90年代的 6 2 .2 %和 5 3.7%。结论 疾病分期、原发灶部位、治疗方法和照射技术影响预后。

Objective To review the multimodality management and outcome of treatment for hypopharyngeal carcinoma accumulated during the past 35 years.Methods 262 hypopharyngeal carcinoma patients treated between Oct. 1962 and Dec. 1997 were retrospectively analyzed. 146 (55.7%) patients received preoperative radiotherapy followed by surgery (R+S),80(30.5%) patients radiotherapy alone (R), 17 (6.5%) patients surgery plus postoperative radiation (S+R) and 19 (7.3%) surgery alone (S). According to the time of treatment ,the management was divided into three periods, the 60s 70s,the 80s and the 90s. The clinical characteristics,method of treatment,radiotherapy technique and results were compared as related to the periods.Results As the treatment improved,the overall 5 year survival and disease free survival rates increased from 14.3% , 23.8% in the 60s and 70s to the 62.2%,53.7% of the 90s.Conclusions Our analysis shows that the stage of disease, site of primary lesion, method,sequence of management and radiotherapeatic technique are important prognostic factors in hypopharyngeal carcinoma.