摘要【目的】探讨下咽癌手术及放化疗的临床效果。【方法】回顾性分析2008年6月至2010年10月本院收治的70例下咽癌病例的临床资料，70例患者根据2002年国际抗癌联盟分期标准，Ⅰ期3例，Ⅱ期10例，Ⅲ期22例，Ⅳ期35例。根据不同的治疗方法，将70例患者分为两组，根治性调强放疗＋化疗组（A组，30例），手术＋术后常规放疗组（B组，40例），术后2～4周伤口完全愈合后进行放疗，比较两组治疗后总生存率和局部控制率。【结果】70例患者的1、3、5年总生存率分别为82．9％（58/70），61．5％（43/70），38．5％（27/70）。A组和B组局部控制率分别为66．7％（20/30），70．0％（28/40），两组相比较差异无显著性（ P ＞0．05）。A组和B组1、3、5年总生存率分别为83．3％（25/30），63．0％（19/30），38．0％（11/30）和82．5％（33/40），58．5％（23/40），39．0％（15/40）。两组1、3、5年生存率相比较差异均无显著性（ P ＞0．05）。【结论】根治性调强放疗＋化疗能获得同手术一样的疗效，且更好地保留了患者的喉功能，提高了生活质量。
Abstract：Objective To explore the efficacy and prognostic factors of comprehensive therapy for hypopharyngeal carcinoma .[Methods]Clinical data of 70 patients with hypopharyngeal carcinoma in our hospital from June 2008 to Oct . 2010 were analyzed retrospectively .According to 2002 international union against cancer (UICC) staging standard ,3 pa-tients were stageⅠ,and 10 patients were stageⅡ ,and 22 patients were stage Ⅲ and 35 patients were stage IV .According to different treatment methods ,70 patients were divided into radical intensity modulated radiation therapy plus chemother-apy group(group A ,n=30) and surgery plus postoperative routine radiation group (group B ,n=40) .Radiotherapy was given 2~4 weeks after the complete healing of postoperative wound .[Results] The 1-,3- and 5-year overall survival rates of all 70 patients were 82 .9% (58/70) ,61 .5% (43/70) and 38 .5% (27/70) ,respectively .The local control rates of group A and group B were 66 .7% (20/30) and 70 .0% (28/40) respectively ,but there was no significant difference be-tween two groups( P>0 .05) .The 1-,3-and 5-year overall survival rates of group A and group B were 83 .3% (25/30) ,63 .0% (19/30) ,38 .0% (11/30) ,82 .5% (33/40) ,58 .5% (23/40) and 39 .0% (15/40) respectively ,but there was no significant difference between two groups ( P>0 .05) .[Conclusion]Radical intensity modulated radiation therapy combined with chemotherapy can not only obtain the same efficacy as surgery ,but also keep the laryngeal function of pa-tients and improve the quality of life .
2014, Vol. 31 
