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目的 分析单纯放射治疗早期声门型喉癌 (T1N0M0 )的预后因素。方法 195 8年 8月至 1994年 12月 ,肿瘤医院共收治行单纯放射治疗的T1N0M0声门型喉鳞癌 2 38例 ,其中男性 2 2 0例 ,女性 18例。用 6、8MVX射线或60 Co予平行对穿野放射治疗 ,中位放射总剂量为 6 8Gy ,中位治疗时间5 2d ,中位放射野大小 2 2 .5cm2 。用Kaplan Meier法计算生存率和局部控制率 ,Logrank法做差异检验 ,Cox回归法统计影响局部控制率 (LC)和总生存率 (OS)的预后因素。结果 中位随访时间 12 7个月 (4～ 410个月 )。 5、10年总生存率分别为 84.0 %和 74.9%。 5年局部控制率为 82 .2 %。 44例在随访过程中出现局部复发 (4 1例为原发部位复发 ,2例为颈部淋巴结复发 ,1例因失访复发部位不详 ) ,2 3例出现第二原发肿瘤。对LC不利的预后影响因素为局部大肿块、前联合受侵和治疗过程中血红蛋白下降。结论 单纯放射治疗T1N0M0声门型喉癌可得到很好的局部控制率 ,但局部大肿块、前联合受侵和血红蛋白在治疗过程中下降是对局部控制不利的预后因素。
Objective To analyze the prognostic factors of early glottic laryngeal carcinoma (T1N0M0) treated with radiotherapy alone. Methods From August 2008 to December 1994, Tumor Hospital received a total of 2 38 cases of T1N0M0 glottic laryngeal squamous cell carcinoma treated with radiotherapy alone, including 220 males and 18 females. With 6,8 MVV rays or 60 Co to the parallel field radiation therapy, the median total dose of radiation 6 8Gy, the median treatment time 52d, the median radiation field size of 22.5cm2. Kaplan-Meier method was used to calculate the survival rate and local control rate. Logrank method was used to test the difference. Cox regression method was used to estimate the prognostic factors of local control rate (LC) and overall survival rate (OS). Results The median follow-up time was 12 7 months (range 4 to 410 months). The 5-year and 10-year overall survival rates were 84.0% and 74.9% respectively. 5-year local control rate of 82.2%. Forty-four patients had local recurrence during the follow-up (41 cases had primary site recurrence, 2 cases had cervical lymph node recurrence, and 1 case had unknown recurrence site). Twenty-three patients had the second primary tumor. The unfavorable prognostic factors for LC are large, locally enlarged masses, a decrease in hemoglobin during the previous combined invasion and treatment. Conclusions Radiotherapy of T1N0M0 glottic laryngeal carcinoma can achieve a good local control rate. However, local large lumps, previous combined invasion and hemoglobin decrease during treatment are unfavorable prognostic factors for local control.