手术联合同期放化疗治疗早期鼻咽癌患者的前瞻性研究

[A prospective study of surgery combined with concurrent radiochemotherapy in the treatment of patients with early stage nasopharyngeal carcinoma].

作者信息

Si Yongfeng, Tao Zhongqiang, Zhang Zheng, Qin Yangda, Zhou Fuling, Huang Bo, Lu Jinlong, Li Bing, Lan Guiping, Weng Jingjin

机构信息

Department of Otorhinolaryngology-Head and Neck Neoplasm, Institute of Nasopharyngeal Carcinoma, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, China.

出版信息

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2012 May;26(9):422-5.

PMID:22803412

Abstract

OBJECTIVE

To investigate the clinical value that surgical treatment with comprehensive treatment in treating early stage nasopharyngeal carcinoma.

METHOD

Based on the case selection criteria, patients with early nasopharyngeal carcinoma were divided into surgery group and the conventional group according to patients' wishes. Surgery group were treated with surgery plus Radiochemotherapy as a comprehensive treatment while conventional group were treated with Radiochemotherapy. Outcome indices: (1) 5-year survival rate and 5-year disease-free survival rate; (2) Radiation dose to the nasopharynx; (3) Incidence of xerostomia.

RESULT

(1) The overall 5-year follow-up rate was 97.12%; 1 patient was lost to follow-up in surgical group, the 5-year follow-up rate was 96.77%; 2 patients were lost in conventional Group with 5-year rate of 97.26%. (2) The 5-year survival rate of 104 patients was 83.65% (87/104). (3) The 5-year survival rate and 5-year tumor-free survival rate were 96.77% (30/31) and 93.55% (29/31) in surgical group, 78.08% (57/73) and 73.97% (54/73) in conventional group. There were significant differences between the two groups (P < 0.05). (4) The radiation dose to the nasopharynx in surgery group and conventional group were (63.90 +/- 5.56) Gy and (71.48 +/- 4.18)Gy, respectively; the dose in surgical group was significantly less than the conventional group, there were statistical significance between the two groups. (5) The incidence of xerostomia was significantly less in surgical group (22.58%) than conventional group (65.75%), the difference was statistically significant.

CONCLUSION

The surgery combined with concurrent chemoradiotherapy is a effective comprehensive therapeutic interchange program for early stage nasopharyngeal carcinoma. These program can increase the long-term survival rate, but also reduce the radiation dose to the nasopharynx and the occurrence of radiation complications. A further aspect is worth consideration.

摘要

目的

探讨手术联合综合治疗在早期鼻咽癌治疗中的临床价值。

方法

根据病例选择标准，早期鼻咽癌患者根据患者意愿分为手术组和传统组。手术组采用手术加放化疗作为综合治疗，而传统组采用放化疗。观察指标：（1）5年生存率和5年无病生存率；（2）鼻咽部放疗剂量；（3）口干症发生率。

结果

（1）总体5年随访率为97.12%；手术组1例失访，5年随访率为96.77%；传统组2例失访，5年随访率为97.26%。（2）104例患者的5年生存率为83.65%（87/104）。（3）手术组5年生存率和5年无瘤生存率分别为96.77%（30/31）和93.55%（29/31），传统组分别为78.08%（57/73）和73.97%（54/73）。两组间差异有统计学意义（P<0.05）。（4）手术组和传统组鼻咽部放疗剂量分别为（63.90±5.56）Gy和（71.48±4.18）Gy；手术组剂量明显低于传统组，两组间有统计学意义。（5）手术组口干症发生率（22.58%）明显低于传统组（65.75%），差异有统计学意义。