[内镜手术联合化疗和放疗对高发地区早期鼻咽癌患者预后的影响]
[Effect of endoscopic surgery combined with chemotherapy and radiotherapy on prognosis of early nasopharyngeal carcinoma patients in high incidence area].
作者信息
Weng Jingjin, Gao Junxiao, Li Min, Wei Jiazhang, Zhang Shaojie, Lan Guiping, Li Bing, Qin Danxue, Huang Bo, Zhu Zhenchao, Su Xiaomei, Peng Yaqi, Qu Shenhong, Qiu Qianhui
机构信息
Department of Otolaryngology Head and Neck Surgery，the People's Hospital of Guangxi Zhuang Autonomous Region，Nanning，530021，China.
Department of Otolaryngology，Zhujiang Hospital，Southern Medical University.
出版信息
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2024 Jun;38(6):472-476;484. doi: 10.13201/j.issn.2096-7993.2024.06.004.
To investigate the differences in the therapeutic effects of endoscopic surgery combined with chemotherapy and endoscopic surgery combined with radiotherapy in the treatment of early nasopharyngeal carcinoma, and to select individualized treatment strategy for early nasopharyngeal carcinoma. The clinical data of 68 patients with early nasopharyngeal carcinoma（T1-2N₀M₀） who received surgical treatment in a high-incidence area were retrospectively analyzed. According to different treatment methods, they were divided into the surgery + chemotherapy group（=34, treated with endoscopic surgery combined with chemotherapy） and the surgery + radiotherapy group（=34, treated with endoscopic surgery combined with radiotherapy）. Propensity score matching was used to match the patient data between the two groups at a 1∶1 ratio. Patients were followed up, and the survival rates and hematological toxicities were compared between the two groups. Twenty-four cases in the surgery + chemotherapy group and 24 cases in the surgery + radiotherapy group were successfully matched. After matching, there was no statistically significant difference in T stage, and clinical stage between the two groups（all >0.05）. The 3-year OS and DFS in the surgery + chemotherapy group were 100.0% and 95.8%, respectively, while the 3-year OS and DFS in the surgery + radiotherapy group were 100.0% and 100.0%, respectively, with no significant difference in survival rates between the two groups（both >0.05）. After treatment, there was no statistically significant difference in bone marrow suppression between the surgery + chemotherapy group and the surgery + radiotherapy group （all > 0.05） Endoscopic surgery combined with chemotherapy and surgery combined with radiotherapy have comparable clinical efficacy in the treatment of early nasopharyngeal carcinoma, but without radiotherapy-related complications, which is worth further investigation.
探讨内镜手术联合化疗与内镜手术联合放疗治疗早期鼻咽癌的疗效差异，为早期鼻咽癌选择个体化治疗策略。回顾性分析高发地区68例接受手术治疗的早期鼻咽癌（T₁-₂N₀M₀）患者的临床资料。根据不同治疗方法，将其分为手术+化疗组（n = 34，采用内镜手术联合化疗）和手术+放疗组（n = 34，采用内镜手术联合放疗）。采用倾向评分匹配法按1∶1比例对两组患者数据进行匹配。对患者进行随访，比较两组的生存率和血液学毒性。手术+化疗组24例与手术+放疗组24例成功匹配。匹配后，两组T分期和临床分期差异无统计学意义（均P>0.05）。手术+化疗组3年总生存率（OS）和无病生存率（DFS）分别为100.0%和95.8%，手术+放疗组3年OS和DFS分别为100.0%和100.0%，两组生存率差异无统计学意义（均P>0.05）。治疗后，手术+化疗组与手术+放疗组骨髓抑制差异无统计学意义（均P>0.05）。内镜手术联合化疗与手术联合放疗治疗早期鼻咽癌临床疗效相当，但无放疗相关并发症，值得进一步研究。
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