诱导化疗治疗伴有颈段食管受侵的下咽癌的个体化治疗：一项回顾性队列研究。
Induction chemotherapy for the individualised treatment of hypopharyngeal carcinoma with cervical oesophageal invasion: a retrospective cohort study.
机构信息
Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, affiliated with Capital Medical University, Beijing, 100730, China.
出版信息
World J Surg Oncol. 2020 Dec 11;18(1):330. doi: 10.1186/s12957-020-02095-0.
BACKGROUND
This study aimed to evaluate the potential of induction chemotherapy as an indicator of the management of advanced hypopharyngeal carcinoma with cervical oesophageal invasion.
METHODS
Sixty-eight patients admitted to our hospital between February 2003 and November 2016 with stage IVB hypopharyngeal carcinoma with cervical oesophageal invasion were retrospectively analysed. Patients were divided into two groups according to the treatment they selected following an explanation of the different treatments available. Patients in group A received induction chemotherapy and had (1) complete/partial remission following chemotherapy and radiotherapy/concurrent chemoradiotherapy or (2) stable disease following chemotherapy and surgery. Patients in group B underwent surgery followed by adjuvant radiotherapy/concurrent chemoradiotherapy. Survival analyses were performed using the Kaplan-Meier method, and differences between the groups were evaluated using the log-rank test. Laryngeal and oesophageal retention rates were compared using the cross-tabulation test.
RESULTS
The 3- and 5-year overall survival rates were 22.86% and 11.43% in group A and 24.25% and 6.06% in group B, respectively (all P > 0.05). The laryngeal and oesophageal retention rates were 40.0% and 74.3% in group A and 0.0% and 27.3% in group B, respectively (all P < 0.01). There was no statistically significant difference in the incidence of post-operative complications between the two groups (group A 8.6%, group B 12.1%; P > 0.05).
CONCLUSIONS
Induction chemotherapy may be an appropriate first choice to ensure laryngeal and oesophageal preservation in the individualised treatment of advanced hypopharyngeal carcinoma with cervical oesophageal invasion.
背景
本研究旨在评估诱导化疗作为评估伴有颈段食管侵犯的晚期下咽癌治疗的指标的潜力。
方法
回顾性分析 2003 年 2 月至 2016 年 11 月我院收治的 68 例 IVB 期伴有颈段食管侵犯的下咽癌患者。根据患者选择的不同治疗方法，将其分为两组。A 组患者接受诱导化疗，化疗后行放化疗/同期放化疗，疗效评估为完全缓解/部分缓解或化疗后行手术，且肿瘤稳定；B 组患者行手术治疗，术后行辅助放化疗/同期放化疗。采用 Kaplan-Meier 法进行生存分析，采用对数秩检验比较组间差异。采用交叉表检验比较两组的喉及食管保留率。
结果
A 组 3 年和 5 年总生存率分别为 22.86%和 11.43%，B 组分别为 24.25%和 6.06%（均 P>0.05）。A 组喉及食管保留率分别为 40.0%和 74.3%，B 组分别为 0.0%和 27.3%（均 P<0.01）。两组术后并发症发生率差异无统计学意义（A 组 8.6%，B 组 12.1%；P>0.05）。
结论
诱导化疗可能是确保伴有颈段食管侵犯的晚期下咽癌个体化治疗中保留喉及食管的合理首选方案。
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