CAJ | 학술논문

目的探讨舌体鳞癌患者不同治疗模式的治疗效果.方法回顾分析2003-2011年间在本院首治的经病理确诊且随访资料完整的舌体鳞癌患者132例临床资料.Kaplan-Meier法计算单纯手术(S)、单纯放疗(R)、手术+放疗(S+R)、化疗+手术(C+S)、化疗+放疗(C+R)、手术+放疗+化疗(S+R+C)各组OS,组间差异采用Logrank法检验.Cox回归模型多因素预后分析确立有影响的治疗模式.结果 3年随访率为100％.3年样本数为94例.全组患者3年OS为72.7％.单因素分析显示70例Ⅰ+Ⅱ期患者中S、R、S+R、C+S、S+R+C的分别为86％、67％、97％、100％、82％ (P =0.018),62例Ⅲ+Ⅳ期患者中S、R、S+R、C+S、C+R、S+R+C的分别为38％、14％、92％、40％、14％、67％(P=0.000).多因素分析显示S+R、S+R+C是影响预后的因素(P=0.000、0.005).结论 Ⅰ～Ⅱ期行手术或手术为主综合治疗疗效较好,Ⅲ～Ⅳ期行以手术为主综合治疗预后较好,其中S+R、S+R+C是较好的治疗模式,对中晚期病例行R、C+R预后差.
목적 탐토설체린암환자불동치료모식적치료효과.방법 회고분석2003-2011년간재본원수치적경병리학진차수방자료완정적설체린암환자132례림상자료.Kaplan-Meier법계산단순수술(S)、단순방료(R)、수술+방료(S+R)、화료+수술(C+S)、화료+방료(C+R)、수술+방료+화료(S+R+C)각조OS,조간차이채용Logrank법검험.Cox회귀모형다인소예후분석학립유영향적치료모식.결과 3년수방솔위100％.3년양본수위94례.전조환자3년OS위72.7％.단인소분석현시70례Ⅰ+Ⅱ기환자중S、R、S+R、C+S、S+R+C적분별위86％、67％、97％、100％、82％ (P =0.018),62례Ⅲ+Ⅳ기환자중S、R、S+R、C+S、C+R、S+R+C적분별위38％、14％、92％、40％、14％、67％(P=0.000).다인소분석현시S+R、S+R+C시영향예후적인소(P=0.000、0.005).결론 Ⅰ～Ⅱ기행수술혹수술위주종합치료료효교호,Ⅲ～Ⅳ기행이수술위주종합치료예후교호,기중S+R、S+R+C시교호적치료모식,대중만기병례행R、C+R예후차.
Objective To analyze the therapeutic effects of different treatment modalities in patients with tongue squamous cell carcinoma.Methods A retrospective analysis was performed on the complete clinical and follow-up data of 132 patients with pathologically confirmed tongue squamous cell carcinoma,who were initially treated at the First Affiliated Hospital of Xinjiang Medical University from 2003 to 2011.The Kaplan-Meier method was used to calculate the overall survival (OS) rates for patients who received surgery alone (S),radiotherapy alone (R),surgery plus radiotherapy (S + R),chemotherapy plus surgery (C + S),chemotherapy plus radiotherapy (C + R),and surgery,radiotherapy,and chemotherapy (S + R + C).The OS was compared between these groups by log-rank test.Multivariate analysis was performed using the Cox proportional hazard model to establish independent treatment modalities as prognostic factors.Results The follow-up rate was 100％.The 3-year sample size was 94.The 3-year OS rate for all patients was 72.7％.The univariate analysis showed that among 70 stage Ⅰ and Ⅱ patients,the S,R,S + R,C + S,and S + R + C groups had 3-year OS rates of 86％,67％,97％,100％,and 82％,respectively (P =0.018) ;among 62 stage Ⅲ and Ⅳ patients,the S,R,S + R,C + S,C + R,and S + R + C groups had 3-year OS rates of 38％,14％,92％,40％,14％,and 67％,respectively (P =0.000).The multivariate analysis showed that S + R and S + R + C were independent prognostic factors (P =0.000 and 0.005).onclusions Surgery alone or combination therapy including surgery has a good therapeutic effect for stage Ⅰ-Ⅱ tongue squamous cell carcinoma,while S + R and S + R + C are better treatment modalities for stage Ⅲ-Ⅳ disease;however,advanced patients have a poor prognosis after being treated with R and C + R modalities.