177例喉癌患者的治疗及预后分析

发布时间：2018-02-27 21:15

本文关键词： 喉恶性肿瘤手术治疗放射治疗生存率预后　出处：《汕头大学》2011年硕士论文　论文类型：学位论文

【摘要】：目的:总结喉癌患者的治疗效果;探讨影响预后的相关因素;探索喉癌的临床治疗策略。方法:回顾性分析我院自2000年1月至2008年12月收治的177例喉鳞癌患者的临床资料(包括性别、年龄、肿瘤部位、T分期、N分期、临床分期、治疗方式和是否行喉全切除术)及治疗转归。应用Kaplan-Meier进行生存率分析。单因素分析用Log-rank检验,多因素分析采用Cox比例风险模型。结果:177例喉癌患者中,Ⅰ、Ⅱ、Ⅲ、Ⅳ期的2年,5年总生存率分别为91.5%,76.9%,61.1%,52.5%,和79.5%,70.1%,51.7%,41.4%。112例声门型喉癌和65例声门上型喉癌的5年生存率分别为69.9%和40.4%,声门型喉癌总生存状况优于声门上型喉癌(P=0.000)。放疗组与手术组喉保留率分别为94.2%,57.5%,放疗组喉保留率优于手术组(P=0.000)。Ⅰ/Ⅱ期喉癌患者手术组和放疗组的生存状况差别无统计学意义。Ⅲ期喉癌患者手术组和放疗组的5年生存率分别为76.9%、37.2%(P=0.029),Ⅳ期喉癌患者手术组和放疗组的5年生存率分别为58.1%、25.7%(P=0.014)。晚期声门上型喉癌手术组和放疗组的5年生存率分别为63.1%、27.0%(P=0.012)。单因素分析发现肿瘤部位、临床分期、T分期、N分期、治疗方式对预后有影响(P分别为0.000,0.001,0.004,0.000,0.001)。Cox模型分析发现治疗方式、T分期、N分期是影响预后的独立因素。结论:喉癌的生存率随T分期、N分期的增高而下降。影响喉癌生存率的主要因素是T分期、N分期和治疗方式。Ⅲ、Ⅳ期喉癌手术治疗的疗效优于放疗患者。声门型喉癌总生存状况优于声门上型喉癌。晚期喉癌应首选以手术为主的综合治疗。
[Abstract]:Objective: To summarize the therapeutic effect of the patients with larynx cancer, to explore the related factors affecting the prognosis, and to explore the clinical treatment strategy of larynx cancer.
Methods: a retrospective analysis of the clinical data of 177 cases of laryngeal squamous cell carcinoma patients in our hospital from January 2000 to December 2008 were the (including gender, age, tumor location, T stage, N stage, clinical stage, treatment and total laryngectomy) and treatment outcome. The application of Kaplan-Meier for the survival analysis. Single factor analysis Log-rank test, multivariate analysis using Cox proportional hazard model.
Results: 177 cases of laryngeal cancer patients, I, II, III, IV period of 2 years, 5 years total survival rates were 91.5%, 76.9%, 61.1%, 52.5%, and 79.5%, 70.1%, 51.7%, 5 year survival rate of 41.4%.112 patients with glottic carcinoma and 65 cases of supraglottic carcinoma were 69.9% and 40.4% and the survival rate of glottic carcinoma than supraglottic carcinoma (P=0.000). The radiotherapy group and operation group of larynx preservation rate were 94.2%, 57.5%, the retention rate of laryngeal radiotherapy group than in surgery group (P=0.000). There was no significant difference between I / II patients with laryngeal cancer surgery group and radiotherapy group 5 years survival survival. The rate of stage III patients with laryngeal cancer surgery group and radiotherapy group were 76.9%, 37.2% (P=0.029), the 5 year survival rate of stage IV patients with laryngeal cancer surgery group and radiotherapy group were 58.1%, 25.7% (P=0.014). The 5 year survival rate of advanced supraglottic laryngeal cancer - surgery group and radiotherapy group were 63.1% and 27% (P=0.012). Single factor analysis showed that the swelling Tumor location, clinical stage, T stage, N stage and treatment mode had an impact on prognosis (P = 0.000,0.001,0.004,0.000,0.001)..Cox model analysis showed that treatment modalities, T staging and N staging were independent prognostic factors.
Conclusion: the survival rate of patients with laryngeal carcinoma T staging, N staging increased and decreased. The main factors affecting the survival rate of laryngeal carcinoma is T staging, N staging and therapy. III, IV stage laryngeal carcinoma surgical treatment curative effect is better than that of radiotherapy patients. The survival rate of glottic carcinoma than supraglottic carcinoma. Late stage laryngeal carcinoma should be integrated the first choice of treatment based on surgery.

【学位授予单位】：汕头大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R739.65

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