CAJ | 학술논문

目的：比较晚期喉咽癌术后同步放化疗与术后单纯放疗的疗效。方法：72例晚期喉咽癌患者手术后接受单纯放疗37例(放疗组),其中保留喉功能(保喉)手术者20例,非保喉手术者17例；手术后进行同步放疗与化疗35例(同步放化疗组),其中保喉手术者24例,非保喉手术者11例。比较2组生存率和生活质量,同时比较保喉者(44例)与非保喉者(28例)生存率。结果：放疗组患者3年生存率48.65%,5年生存率24.32%；同步放化疗组患者3年生存率71.43%,5年生存率48.57%,2组患者3年和5年生存率差异均有统计学意义(P<0.05)；2组不良反应发生率差异均无统计学意义(P>0.05)；2组患者咽瘘发生率以及吞咽、语言功能恢复情况差异均无统计学意义(P>0.05)。保喉者3年生存率40.90%,5年生存率27.27%,非保喉者3年生存率60.71%,5年生存率39.28%,2组患者3年和5年生存率差异均无统计学意义(P>0.05)。结论：晚期喉咽癌患者术后进行同步放化疗比术后单纯放疗3年及5年生存率高,且不增加不良反应,不影响患者术后生活质量；保喉手术与非保喉手术3年和5年生存率均无明显不同,可根据患者情况尽量保留喉功能。
목적：비교만기후인암술후동보방화료여술후단순방료적료효。방법：72례만기후인암환자수술후접수단순방료37례(방료조),기중보류후공능(보후)수술자20례,비보후수술자17례；수술후진행동보방료여화료35례(동보방화료조),기중보후수술자24례,비보후수술자11례。비교2조생존솔화생활질량,동시비교보후자(44례)여비보후자(28례)생존솔。결과：방료조환자3년생존솔48.65%,5년생존솔24.32%；동보방화료조환자3년생존솔71.43%,5년생존솔48.57%,2조환자3년화5년생존솔차이균유통계학의의(P<0.05)；2조불량반응발생솔차이균무통계학의의(P>0.05)；2조환자인루발생솔이급탄인、어언공능회복정황차이균무통계학의의(P>0.05)。보후자3년생존솔40.90%,5년생존솔27.27%,비보후자3년생존솔60.71%,5년생존솔39.28%,2조환자3년화5년생존솔차이균무통계학의의(P>0.05)。결론：만기후인암환자술후진행동보방화료비술후단순방료3년급5년생존솔고,차불증가불량반응,불영향환자술후생활질량；보후수술여비보후수술3년화5년생존솔균무명현불동,가근거환자정황진량보류후공능。
Objective:To explore the clinical effects of postoperative chemoradiation and radiotherapy on advanced hypopharyngeal carcinoma. Methods:Thirty-seven patients with advanced hypopharyngeal carcinoma( including 20 cases with laryngeal function and 17 cases without laryngeal function ) were treated with radiotherapy after surgery ( radiotherapy group ) , 35 patients with advanced hypopharyngeal carcinoma ( including 24 cases with laryngeal function and 11 cases without laryngeal function ) were treated with chemoradiation after surgery(chemoradiation group). The survival rate and life quality of two groups were compared,and the survival rate of patients with and without laryngeal function was compared. Results:The 3-year and 5-year survival rates in radiotherapy group and chemoradiation group were 48. 65% & 71. 43% and 24. 32% & 48. 57%,respectively,the difference of which was statistically significant(P<0. 05). The differences of the incidence rates of toxicity and pharyngeal fistula,and the swallowing function and linguistic function recovery in two groups were not statistically significant(P>0. 05). The 3-year and 5-year survival rates in patients with and without without laryngeal function were 40. 90% &60. 71% and 27. 27% &39. 28%,respectively,the difference of which was not statistically significant(P>0. 05). Conclusions:The survival rates of 3- and 5-year of patients with advanced hypopharyngeal carcinoma treated with chemoradiation are higher than those of patients treated only with radiotherapy,the treatment does not increase the toxicity and affect the life quality of postoperative patients. The survival rates of 3-and 5-year of patients with and without laryngeal function are similar,and the laryngeal function can be preserved according to the disease.