本文關(guān)鍵詞： 喉惡性腫瘤 手術(shù)治療 放射治療 生存率 預(yù)后　出處：《汕頭大學(xué)》2011年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:總結(jié)喉癌患者的治療效果;探討影響預(yù)后的相關(guān)因素;探索喉癌的臨床治療策略。 方法:回顧性分析我院自2000年1月至2008年12月收治的177例喉鱗癌患者的臨床資料(包括性別、年齡、腫瘤部位、T分期、N分期、臨床分期、治療方式和是否行喉全切除術(shù))及治療轉(zhuǎn)歸。應(yīng)用Kaplan-Meier進(jìn)行生存率分析。單因素分析用Log-rank檢驗(yàn),多因素分析采用Cox比例風(fēng)險(xiǎn)模型。 結(jié)果:177例喉癌患者中,Ⅰ、Ⅱ、Ⅲ、Ⅳ期的2年,5年總生存率分別為91.5%,76.9%,61.1%,52.5%,和79.5%,70.1%,51.7%,41.4%。112例聲門型喉癌和65例聲門上型喉癌的5年生存率分別為69.9%和40.4%,聲門型喉癌總生存狀況優(yōu)于聲門上型喉癌(P=0.000)。放療組與手術(shù)組喉保留率分別為94.2%,57.5%,放療組喉保留率優(yōu)于手術(shù)組(P=0.000)。Ⅰ/Ⅱ期喉癌患者手術(shù)組和放療組的生存狀況差別無統(tǒng)計(jì)學(xué)意義。Ⅲ期喉癌患者手術(shù)組和放療組的5年生存率分別為76.9%、37.2%(P=0.029),Ⅳ期喉癌患者手術(shù)組和放療組的5年生存率分別為58.1%、25.7%(P=0.014)。晚期聲門上型喉癌手術(shù)組和放療組的5年生存率分別為63.1%、27.0%(P=0.012)。單因素分析發(fā)現(xiàn)腫瘤部位、臨床分期、T分期、N分期、治療方式對(duì)預(yù)后有影響(P分別為0.000,0.001,0.004,0.000,0.001)。Cox模型分析發(fā)現(xiàn)治療方式、T分期、N分期是影響預(yù)后的獨(dú)立因素。 結(jié)論:喉癌的生存率隨T分期、N分期的增高而下降。影響喉癌生存率的主要因素是T分期、N分期和治療方式。Ⅲ、Ⅳ期喉癌手術(shù)治療的療效優(yōu)于放療患者。聲門型喉癌總生存狀況優(yōu)于聲門上型喉癌。晚期喉癌應(yīng)首選以手術(shù)為主的綜合治療。
[Abstract]:Objective: To summarize the therapeutic effect of the patients with larynx cancer, to explore the related factors affecting the prognosis, and to explore the clinical treatment strategy of larynx cancer.
Methods: a retrospective analysis of the clinical data of 177 cases of laryngeal squamous cell carcinoma patients in our hospital from January 2000 to December 2008 were the (including gender, age, tumor location, T stage, N stage, clinical stage, treatment and total laryngectomy) and treatment outcome. The application of Kaplan-Meier for the survival analysis. Single factor analysis Log-rank test, multivariate analysis using Cox proportional hazard model.
Results: 177 cases of laryngeal cancer patients, I, II, III, IV period of 2 years, 5 years total survival rates were 91.5%, 76.9%, 61.1%, 52.5%, and 79.5%, 70.1%, 51.7%, 5 year survival rate of 41.4%.112 patients with glottic carcinoma and 65 cases of supraglottic carcinoma were 69.9% and 40.4% and the survival rate of glottic carcinoma than supraglottic carcinoma (P=0.000). The radiotherapy group and operation group of larynx preservation rate were 94.2%, 57.5%, the retention rate of laryngeal radiotherapy group than in surgery group (P=0.000). There was no significant difference between I / II patients with laryngeal cancer surgery group and radiotherapy group 5 years survival survival. The rate of stage III patients with laryngeal cancer surgery group and radiotherapy group were 76.9%, 37.2% (P=0.029), the 5 year survival rate of stage IV patients with laryngeal cancer surgery group and radiotherapy group were 58.1%, 25.7% (P=0.014). The 5 year survival rate of advanced supraglottic laryngeal cancer - surgery group and radiotherapy group were 63.1% and 27% (P=0.012). Single factor analysis showed that the swelling Tumor location, clinical stage, T stage, N stage and treatment mode had an impact on prognosis (P = 0.000,0.001,0.004,0.000,0.001)..Cox model analysis showed that treatment modalities, T staging and N staging were independent prognostic factors.
Conclusion: the survival rate of patients with laryngeal carcinoma T staging, N staging increased and decreased. The main factors affecting the survival rate of laryngeal carcinoma is T staging, N staging and therapy. III, IV stage laryngeal carcinoma surgical treatment curative effect is better than that of radiotherapy patients. The survival rate of glottic carcinoma than supraglottic carcinoma. Late stage laryngeal carcinoma should be integrated the first choice of treatment based on surgery.

【學(xué)位授予單位】：汕頭大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2011
【分類號(hào)】：R739.65

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