三种治疗模式治疗进展期舌根癌疗效及预后研究

目的]探讨单纯手术、手术加术后放疗及手术加放化疗三种方案对舌根癌的疗效及安全性。方法]回顾性分析1998年1月～2008年8月收治经病理证实的39例进展期舌根癌患者的临床资料．其中单纯手术组（A组）14例，手术加术后放疗组（B组）12例，手术加放化疗组（C组）13例．采用Cox多因素回归模型分析预后影响因素。结果]A、B、C组3年及5年总生存率分别为14.3％、50％、69．2％与7．1％、16．7％、46．2％，Kaplan—Meier法显不C组生存时间明显优于B组．且B组的生存时间优于A组（P〈0．05）。3组在CR、局部控制率、局部区域控制率、毒副反应方面无统计学差异。Cox多因素分析显示T分期、TNM分期、治疗方法、局部区域控制率是影响生存的独立预后因素。结论]手术加放化疗模式治疗进展期舌根癌有较好的局部控制率与远期预后．且未增加毒副反应，是一种有效、安全的方法。

Efficacy of Three Therapeutic Models in the Treatment of Advanced Base Tongue Carcinoma

Purpose] To investigate the efficacy and safety of surgery alone, surgery plus postoperative radiotherapy and surgery plus chemoradiation in the treatment of advanced base tongue cancer. Methods] The clinical data of 39 cases with base tongue cancer pathologically proved from January 1998 to August 2008 were analyzed retrospectively. Fourteen cases underwent surgery alone（group A）; 12, surgery plus postoperative radiotherapy（group B）; 13, surgery plus chemoradiation（group C）. The prognostic factors were analyzed by Cox regression model. Results] The 3-year and 5-year overall survival rate in group A, group B and group C were 14.3%, 50%, 69.2% and 7.1%, 16.7%, 46.2%, respectively. Kaplan-Meier analysis showed the survival time in group C was longer than that in group B, and group B longer than that in group A （P〈0.05）. There was no significantly different of CR, local control, regional control and toxicity among the three therapeutic models. Cox multivariate analysis showed that T stage, TNM stage, therapeutic modality and regional control were independent prognostic factors in progressive stage base tongue cancer. Conclusion ] Induction chemotherapy plus surgery and postoperative radiotherapy is a safety and effectiveness method for advanced base tongue cancer, with good local control and long-term prognosis and without increasing toxicity.