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目的:比较手术加辅助放疗与单纯手术治疗晚期声门上型喉鳞状细胞癌的疗效。方法:将59例晚期声门上型喉鳞状细胞癌按治疗方法分为手术+放疗组(33例)和手术组(26例)。手术+放疗组全喉切除27例,部分切除6例,其中27例行侧颈淋巴结清扫术;手术组全喉切除23例,部分切除3例,其中24例行侧颈淋巴结清扫术。结果:手术+放疗组和手术组的3年总生存率分别为62.6%和62.6%,5年总生存率分别为43.8%和40.5%,经Log-rank检验两组之间的生存率差异无统计学意义(P>0.05)。手术+放疗组5例复发,复发率15.2%;手术组10例复发,复发率38.5%,两组的复发率差异有统计学意义(P<0.05)。结论:手术加辅助放疗未能提高晚期声门上型喉鳞状细胞癌3、5年总生存率,但明显降低肿瘤复发率。
Objective: To compare the efficacy of surgery plus adjuvant radiotherapy and surgery alone in the treatment of advanced supraglottic laryngeal squamous cell carcinoma. Methods: Fifty-nine cases of advanced supraglottic laryngeal squamous cell carcinoma were divided into operation + radiotherapy group (33 cases) and operation group (26 cases) according to the treatment method. In operation + radiotherapy group, there were 27 cases of total laryngectomy and 6 cases of partial resection, of which 27 cases had lateral neck lymph node dissection. The total laryngectomy was performed in 23 cases and the partial resection in 3 cases. Among them, 24 cases had lateral neck lymph node dissection. Results: The 3-year overall survival rates of operation + radiotherapy group and operation group were 62.6% and 62.6%, respectively. The 5-year overall survival rates were 43.8% and 40.5% respectively. There was no significant difference in survival between the two groups by Log-rank test Statistical significance (P> 0.05). The recurrence rate was 15.2% in 5 cases in operation + radiotherapy group. The recurrence rate was 38.5% in 10 cases in operation group. There was significant difference in the recurrence rate between the two groups (P <0.05). Conclusion: Surgery combined with adjuvant radiotherapy failed to improve the overall survival of patients with advanced supraglottic laryngeal squamous cell carcinoma at 3-5 years, but significantly reduced the recurrence rate.