摘要
目的 回顾性分析扁桃体鳞状细胞癌 (简称鳞癌 )治疗的临床资料 ,为研究扁桃体鳞癌治疗方式的选择提供依据。方法 1984～ 2 0 0 0年共治疗 10 8例扁桃体鳞癌患者 ,其中男性 82例 ,女性 2 6例 ,发病年龄 19～ 70岁。治疗分为根治性放射治疗 (简称放疗 83例 )与术前放射加手术 ( 2 5例 )两组。根治性放疗组中 ,再分单纯放疗 ( 5 5例 )和放疗加外科挽救 ( 2 8例 )两组。低分化鳞癌及Ⅰ Ⅱ期扁桃体鳞癌主要选择单纯放疗 ,中、高分化鳞癌及Ⅲ Ⅳ期扁桃体鳞癌主要选择放疗加外科挽救或术前放射加手术。 5年随访率 83 2 % ( 79/ 95 )。采用寿命表法统计 5年生存率。结果 根治性放疗 (包括单纯放疗和放疗加外科挽救 )的 5年生存率为 5 9 3% ,术前放射加手术的 5年生存率为5 5 3% ,差异无统计学意义 (P值 =0 70 5 6 )。 2 2例Ⅰ Ⅱ期患者 5年生存率为 84 2 % ,86例Ⅲ Ⅳ期患者 5年生存率为 5 1 7% ,差异有非常显著性意义 (P值 =0 0 0 5 7)。低分化鳞癌 4 2例 ,中分化鳞癌4 5例 ,高分化鳞癌 19例 ,5年生存率分别为 5 9 8%、4 8 8%和 78 3% ,差异无显著性意义 (P值 =0 2 2 88)。结论 Ⅰ Ⅱ期和低分化扁桃体鳞癌应选择单纯放疗 ,Ⅲ Ⅳ期和中、高分化的扁桃体鳞癌应选择放疗加外科挽救或计划性术前放?
Objective Radiotherapy alone, radiotherapy with salvage surgery, and planned combination of radiotherapy and surgery were treatment modalities for tonsillar squamous cell carcinoma This study is to discuss the treatment planning for this disease Methods Between 1984 and 2000, 108 patients with tonsillar squamous cell carcinoma were reviewed, including 82 males and 26 females, with ages ranging from 19 to 70 years old The treatment was radical radiotherapy in 83 cases and planned preoperative radiation plus surgery in 25 cases 83 cases of radical radiotherapy were further divided into radiotherapy alone (55 cases) and radiotherapy with salvage surgery (28 cases) For patients with lower differentiated squamous cell carcinoma or Ⅰ Ⅱ staged disease the treatment were radiotherapy alone For patients with moderately or well differentiated squamous cell carcinoma or Ⅲ Ⅳ staged disease the treatment were radiotherapy with salvage surgery or planned preoperative radiation plus surgery 83 2% (79/95) of patients were followed up 5 years after treatment or till the death of patient Survival curves were calculated using the life table method Results For radical radiotherapy, including radiotherapy alone and radiotherapy with salvage surgery, 5 years survival was 59 3% For planned preoperative radiation plus surgery, 5 years survival was 55 3% The difference between the two treatments was not significant in statistics ( P =0 705 6) For Ⅰ Ⅱ staged cases , 5 years survival was 84 2%, and it was 51 7% for Ⅲ Ⅳ staged cases The survival difference between Ⅰ Ⅱ staged and Ⅲ Ⅳ staged patients was significant in statistics ( P =0 005 7) The 5 years survival was 59 8% for 42 cases with lower differentiated, was 48 8% for 45 cases with moderately differentiated , and was 78 3% for 19 cases with well differentiated squamous cell carcinoma, which was not significant in statistics ( P =0 228 8). Conclusion Radiotherapy alone was recommended as the treatment of choice for Ⅰ Ⅱ staged or lower differentiated tonsillar squamous cell carcinoma The radical radiotherapy with salvage surgery or planned preoperative radiation plus surgery were the treatment of choice for Ⅲ Ⅳ staged or well differentiated tonsillar squamous cell carcinoma
出处
《中华耳鼻咽喉科杂志》
CSCD
北大核心
2003年第5期379-382,共4页
Chinese Journal of Otorhinolaryngology
关键词
扁桃体鳞状细胞癌
治疗
扁桃体肿瘤
外科手术
放射疗法
Tonsillar neoplasms
Carcinoma,squamous cell
Radiotherapy
Surgical procedures,operative
Survival rate
