本文選題：單純放療　切入點(diǎn)：復(fù)發(fā)　出處：《山西醫(yī)科大學(xué)》2013年碩士論文　論文類型：學(xué)位論文

【摘要】：背景：喉癌是耳鼻咽喉頭頸外科常見(jiàn)的惡性腫瘤之一,在頭頸部上皮來(lái)源的所有原發(fā)惡性腫瘤中排名第二位。占全身惡性腫瘤的1%-5%。 放射治療喉癌控制率比較高,但也有復(fù)發(fā)。喉癌的殘留和復(fù)發(fā)是臨床的難題,盡管有一些方法能用于喉癌的首次治療,但是復(fù)發(fā)的喉癌,因?yàn)椴∪耸状谓邮苤委煼椒ǖ牟煌?限制了治療方式的選擇。 隨著頭頸部腫瘤外科的迅速發(fā)展,喉癌的研究不斷加深了對(duì)腫瘤的治療認(rèn)識(shí),傳統(tǒng)的全喉切除術(shù)現(xiàn)就已逐漸的被各種新型的喉功能保留的手術(shù)方式。與全喉切除術(shù)相比較,喉部分切除術(shù)能夠在切除癌病灶的情況下,盡可能保全喉部完整性,提高病人的生活質(zhì)量。但是其在放療復(fù)發(fā)癌的治療上的地位并不明確,運(yùn)用不夠廣泛。 目標(biāo)：通過(guò)搜集相關(guān)文獻(xiàn),運(yùn)用系統(tǒng)回顧和meta分析的方法,對(duì)喉部分切除術(shù)治療放療復(fù)發(fā)癌的療效進(jìn)行分析討論。體現(xiàn)出該方法的優(yōu)勢(shì),為臨床治療方法選擇作參考。 方法：制定合適的檢索策略,檢索的數(shù)據(jù)庫(kù)有PunMed、springerlink、萬(wàn)方、中國(guó)知網(wǎng)。檢索年份為1980年-2013年,按照納入排除標(biāo)準(zhǔn)篩選文獻(xiàn),并進(jìn)行質(zhì)量評(píng)估。入選文獻(xiàn)的數(shù)據(jù)錄入Stata12.0中,再用R語(yǔ)言軟件對(duì)其計(jì)算分析和繪圖。 結(jié)果：策略檢索得到文獻(xiàn)630篇,最終39篇入選,病人總數(shù)790人。進(jìn)行質(zhì)量評(píng)估,18篇文章得到6分以上,21篇文章得到4或5分。腫瘤學(xué)的結(jié)果,通過(guò)隨機(jī)效應(yīng)模型計(jì)算集合率得到結(jié)果為：2年以上的局部控制率為86.6%(95%CI,82.2%-90.3%)；5年總體生存率為82.1%(85%CI,77.6%-86.1%)；5年無(wú)病生存率為89.4%(84.4%-93.5%)。提及拔管率的文獻(xiàn)集合率為95.1%(95%CI,92.6%-97.2%),患者數(shù)315人。提及喉保存率的文獻(xiàn)集合率為83.9%(95%CI,80.7%-87%),病人數(shù)為502人。 結(jié)論：現(xiàn)有的資料和數(shù)據(jù)顯示喉部分切除術(shù)對(duì)T1T2期放療復(fù)發(fā)癌癥更為有效,有很高的控制率、無(wú)病生存率和喉保存率�，F(xiàn)有的幾種術(shù)式中,垂直喉部分切除術(shù)和環(huán)狀軟骨上的喉部分切除術(shù)顯得更為有效。
[Abstract]:Background: laryngeal carcinoma is one of the most common malignant tumors in otolaryngopharyngeal head and neck surgery. It ranks second among all primary malignant tumors of head and neck epithelium. Although there are some methods that can be used for the first treatment of laryngeal cancer, the recurrence of laryngeal cancer is due to the difference of the first treatment method. It limits the choice of treatment. With the rapid development of head and neck tumor surgery, the study of laryngeal cancer has deepened the understanding of the treatment of tumor. Traditional total laryngectomy has been gradually preserved by various new laryngeal function surgery, compared with total laryngectomy. Partial laryngectomy can preserve the integrity of larynx and improve the quality of life in the case of resection of cancer lesions, but its role in the treatment of recurrent cancer by radiotherapy is not clear and is not widely used. Objective: to analyze and discuss the curative effect of partial laryngectomy in the treatment of recurrent cancer by means of systematic review and meta analysis. Methods: a suitable retrieval strategy was established. The databases were PunMedspringerlink, Wanfang and China.The retrieval year was from 1980 to 2013. The literature was screened according to the exclusion criteria and the quality was evaluated. The data of the selected documents were entered into Stata12.0. Then R language software is used to calculate, analyze and plot it. Results: a total of 630 articles and 39 articles were selected, and the total number of patients was 790. Quality assessment was conducted in 18 articles with a score of more than 6 and 21 articles with a score of 4 or 5. The results of oncology were obtained. The results obtained by the random effect model are as follows: the local control rate of more than 2 years is 82.2- 90.33; the overall 5-year survival rate is 82.1 and 85CI77.6-86.1; the 5-year disease-free survival rate is 89.44.4- 93.55.The collection rate of the literature with reference to extubation rate is 95.1C 95CI92.6-97.20.The number of patients mentioned is 315. The 5-year disease-free survival rate is 89.44.4- 93.55.The collection rate of the literature with reference to extubation rate is 95.1C 95CI92.6-97.2U, and the number of patients is 315. The collection rate of the literature was 83.9% and the number of patients was 502. Conclusion: the available data and data show that partial laryngectomy is more effective in the treatment of recurrent cancer after T1T2 stage radiotherapy, with a high control rate, disease-free survival rate and laryngeal preservation rate. Vertical partial laryngectomy and partial laryngectomy on annular cartilage are more effective.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R739.65

【參考文獻(xiàn)】

相關(guān)期刊論文 前5條

1 曾祥發(fā)，胡永紅，，張恩羆;喉癌的放射治療（附323例10年療效分析）[J];癌癥;1994年04期

2 劉隆躍,周天明,詹必武;手術(shù)治療喉癌根治性放療后復(fù)發(fā)病人13例報(bào)告[J];臨床耳鼻咽喉科雜志;1998年11期

3 徐普慶,周頂斌,邱椿林;喉癌根治性放療失敗后的手術(shù)治療[J];現(xiàn)代腫瘤醫(yī)學(xué);2005年06期

4 陳偉祥;61例喉癌單純放射治療臨床分析[J];中國(guó)癌癥雜志;1998年02期

5 羅京偉,徐國(guó)鎮(zhèn),屠規(guī)益;放療在頭頸部癌臨床治療中的作用[J];中華耳鼻咽喉頭頸外科雜志;2005年11期

本文編號(hào)：1575613