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目的研究单纯放疗治疗早期喉癌的疗效及预后因素。方法回顾性分析2003年1月-2008年12月在山西省肿瘤医院接受单纯放射治疗的早期喉癌患者85例。用K-M法进行生存率的计算,Log-rank进行单因素分析,用COX回归行多因素分析。结果单纯放疗组的3、5年总生存率(OS)为92.5%、82%。单纯放疗组首程治疗后的3、5年局部控制率(LC)为82.5%、70%。Cox多因素回归分析显示分期(P=0.032)、鳞癌类型(P=0.025)、年龄(P=0.02)是影响喉癌5年生存率的独立因素。年龄>60岁、治疗前KPS评分<80、T2N0M0喉癌、低分化鳞癌及声门下型喉癌是影响OS的不良预后因素。结论单纯放疗可以作为治疗早期喉癌的首选方法。影响生存率的主要因素为:年龄、治疗前KPS评分、喉癌分期、鳞癌类型及喉癌的分型。
Objective To study the curative effect and prognostic factors of radiotherapy for early laryngeal cancer. Methods A retrospective analysis of 85 patients with early laryngeal cancer who underwent radiotherapy alone at Shanxi Cancer Hospital from January 2003 to December 2008 was performed. Survival rate was calculated by K-M method, univariate analysis was performed by Log-rank, and multivariate analysis was performed by COX regression. Results The 3-year and 5-year overall survival (OS) of the radiotherapy group was 92.5% and 82%, respectively. The local control rates (LCs) at 3 and 5 years after radiotherapy alone were 82.5% and 70%, respectively. Cox regression analysis showed that stage (P = 0.032), squamous cell carcinoma (P = 0.025) and age (P = 0.02) were independent prognostic factors for 5-year survival of laryngeal cancer. Age> 60 years, before treatment KPS score <80, T2N0M0 laryngeal cancer, poorly differentiated squamous cell carcinoma and subglottic laryngeal cancer are adverse prognostic factors of OS. Conclusion Radiotherapy alone can be the first choice for the treatment of early laryngeal cancer. The main factors affecting the survival rate were: age, pre-treatment KPS score, laryngeal cancer staging, squamous cell carcinoma and the classification of laryngeal cancer.