Lu T, Li Z D, Li S C, Li Y G, Liu H W, Jiang L, Huang D N, Wei H M, Liu Z
Department of Head and Neck Surgery, Cancer Hospital of China Medical University, Liaoning Tumour Hospital, Shenyang, 110042, China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2019 Mar;33(3):275-279. doi: 10.13201/j.issn.1001-1781.2019.03.022.
To investigate the clinical characteristics, two different treatment outcomes and prognostic factors of hypopharyngeal carcinoma. The life table method was used to calculate the overall survival rates, Log-rank test was used to compare the overall survival rates between the two groups．The Cox proportional hazard model was used to perform the multivariate analysis to confirm independent treatment modalities as prognostic factors. Among the 321 patients, 197 patients received surgery combine with radiotherapy or concurrent chemoradiotherapy treatment（S+R/CRT） and 124 patients received radiotherapy or concurrent chemoradiotherapy treatment(R/CRT). For 321 patients, the 1,3,5year overall survival rates were 75.87%,49.39%,41.38% and the median survival time was 37.65 months. The difference in throat retention ratio between the radiotherapy or concurrent chemoradiotherapy treatment(41.94%) and surgery combine with radiotherapy or concurrent chemoradiotherapy treatment（11.17%) was statistically significant (<0.01).Univariate analysis showed that clinical stage of tumor, T stage, N stage, M stage and two different treatment modalities have impact on survival prognosis. Cox regression multivariate analysis showed that T stage, N stage, two different treatment modalities were independent risk factors of prognosis. The overall prognosis of hypopharyngeal carcinoma was poor and dismal. Hypopharyngeal carcinoma is characterized by high degree of malignancy, difficult to be found early, prone to recurrence and metastasis after operation, large trauma and poor prognosis. Comprehensive examination should be conducted to define the stage of tumor and choose the rational treatment plan before treatment. Surgery combine with radiotherapy or chemotherapy treatment modality is still the main treatment strategy for advanced-stage hypopharyngeal carcinoma..
为探讨下咽癌的临床特征、两种不同的治疗结局及预后因素。采用寿命表法计算总生存率，采用Log-rank检验比较两组的总生存率。采用Cox比例风险模型进行多因素分析，以确定独立的治疗方式作为预后因素。321例患者中，197例接受手术联合放疗或同步放化疗（S+R/CRT），124例接受单纯放疗或同步放化疗（R/CRT）。321例患者1、3、5年总生存率分别为75.87%、49.39%、41.38%，中位生存时间为37.65个月。单纯放疗或同步放化疗组的保喉率（41.94%）与手术联合放疗或同步放化疗组（11.17%）差异有统计学意义（<0.01）。单因素分析显示，肿瘤临床分期、T分期、N分期、M分期及两种不同治疗方式对生存预后有影响。Cox回归多因素分析显示，T分期、N分期、两种不同治疗方式是独立的预后危险因素。下咽癌总体预后较差。下咽癌具有恶性程度高、早期难发现、术后易复发转移、创伤大、预后差等特点。治疗前应进行全面检查以明确肿瘤分期并选择合理的治疗方案。手术联合放疗或化疗仍是晚期下咽癌的主要治疗策略。
