舌体鳞状细胞癌不同治疗模式疗效分析

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。

Outcomes of tongue squamous cell carcinoma treated with different treatment modalities

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). Conclusions 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.