手术加术前放化疗治疗下咽癌21例临床分析

目的　探讨下咽癌病人的综合疗法 ,提高其生存率 ,保留喉的生理功能。方法　对 2 1例经病理确诊的下咽癌病人 ,其中腺癌6例 ,鳞癌 15例 ,分别采用术前化疗、放疗 ,2周后手术方案。术式包括 :垂直半喉切除 +梨状窝切除 ,3 /4喉切除 +梨状窝切除。合并颈淋巴结转移行同侧颈廓清术。结果　 2 1例中 ,3年生存率 71 4% (15 /2 1) ,5年生存率 61 9% (13 /2 1) ,除 1例全喉下咽切除外 ,18例病人顺利拔管 ,2例拔管困难 ,但发音正常。回顾我科 1988～ 1995年 72例确诊的喉癌 ,并行全喉或部分喉切除病人 ,其 5年生存率为 62 5 % (4 5 /72 ) ,与本组病例无差异。结论　手术联合术前放疗、化疗治疗下咽癌肿 ,既提高病人生存率 ,又保留了喉生理功能 ,是下咽肿瘤理想的治疗方法

Clinical Analysis of 21 Cases'Treatment of Hypopharynx Cancer by Means of Operation and Pre - operational Radio and Chemical Therapy

Objective To explore a comprehensive therapy of hypopharynx cancer and increase patients' sarvival rate and keep back their Largnyes' physiological function. Method Pre-operational radio and chemical therapy was given respectively to 21 hypopharynx cancer cases. 6 of whom suffered from adeno cancer and 15 from squama cancer; and two weeks later, they were given operations, which contained vertical half laryngectomy with hypopharynx cancer cut three fourths laryngectomy plus hypopharynx cut and RND, which was given to those with neck lymph node metastasis. Results In twenty one cases, the 3-year survival rate is 71.4%(15/21).The 5-year survival rate is 61.9%(13/21). Except for one with his whole thraot and hypopharynx cut, 18 cases succeeded in detubation and 2 cases were difficult in detubation but of orthphony. Reviewing 72 definite larynyx cancers from 1988 to 1995 in our department the 5-year survival rate was 62.5%(45/72),which makes little difference from this group. Conclusion Operation combined with pre-radio and chemical therapy on hypophynx cancer both increase patients' survival rate and remains their throats' physio logical function, which is an ideal therapy to hypopharynx.