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[目的]分析手术联合放/化疗和放/化疗联合挽救手术治疗局部晚期下咽癌的临床疗效,并分析影响预后的主要因素,探索其合理的治疗方法。[方法]回顾性分析1999年6月至2009年8月收治的88例下咽鳞癌患者的临床资料。按照治疗方法分为:手术联合放/化疗组(S±R/C,n=22)和放/化疗联合挽救手术组(R/C±S,n=66)。分析对比两组的总生存率(OS)、无复发生存率(RFS)和喉保留率。Cox模型分析影响预后的独立因素。[结果]S±R/C组5年OS、RFS优于R/C±S组(49.2%/45.5%vs 20.6%/17.7%,P<0.05)。喉保留率R/C±S组较S±R/C组高(95.5%vs 22.7%,P<0.05)。治疗方法是影响患者OS、RFS、喉保留率的惟一独立因素。[结论]局部晚期下咽癌采取手术联合放/化疗的生存率高于放/化疗联合挽救手术,而其喉保留率低于后者。局部晚期下咽癌的治疗首选手术为主的治疗。
[Objective] To analyze the clinical efficacy of surgery combined with radiotherapy / radiotherapy and radiotherapy / radiotherapy in the treatment of locally advanced hypopharyngeal carcinoma, and to analyze the main factors affecting the prognosis and explore its reasonable treatment methods. [Methods] The clinical data of 88 patients with hypopharyngeal squamous cell carcinoma admitted from June 1999 to August 2009 were retrospectively analyzed. According to the treatment methods, they were divided into operation combined radiotherapy and chemotherapy group (S ± R / C, n = 22) and radiotherapy / chemotherapy combined with salvage operation group (R / C ± S, n = 66). The overall survival (OS), recurrence-free survival (RFS) and laryngeal retention were compared between the two groups. Cox model analysis of prognostic independent factors. [Results] The 5-year OS and RFS in S ± R / C group were better than those in R / C ± S group (49.2% / 45.5% vs 20.6% / 17.7%, P <0.05). The laryngeal retention rate in R / C ± S group was higher than that in S ± R / C group (95.5% vs 22.7%, P <0.05). The treatment method is the only independent factor affecting the OS, RFS, laryngeal retention rate. [Conclusion] The survival rate of locally advanced hypopharyngeal carcinoma treated with radiotherapy and chemotherapy is higher than that of radiotherapy / chemotherapy combined with salvage surgery, while the laryngeal retention rate is lower than that of the latter. The treatment of locally advanced hypopharyngeal cancer preferred surgery-based treatment.