下咽环后区癌 39例临床分析

背景与目的：下咽环后区癌的恶性程度较高,目前临床上有多种治疗方法,但总体疗效欠佳。本研究试图通过两种不同治疗方法的对比研究,以寻求对环后区癌更有效的治疗方法。方法：收集本院39例环后区癌的临床资料,分别根据环后区癌的原发灶侵袭情况,区域淋巴结的转移情况分组,总结并分析两种不同方法治疗的患者的生存率差别。结果：综合治疗组（手术 术后放疗）的3年及5年生存率均高于单纯放疗组,且有显著性差异。随诊中复发者72.2%(13/18)出现对侧（双侧）颈淋巴结转移,结论：综合治疗（手术 术后放疗）是环后区癌有效的治疗方法。密切关注对侧（双侧）颈淋巴结的转移情况,并积极处理,有可能提高环后区癌的生存率。

Clinical study of 39 cases of inferior postcricoid carcinoma

BACKGROUND &OBJECTIVE: There were many treatment strategies for inferior postcricoid carcinoma; however, the total survival rates were not so good till now. This study was designed to investigate the effective method for treatment of inferior postcricoid carcinoma. METHODS: Thirty nine cases of inferior postcricoid carcinoma from 1970 to 1997 in Department of Head and Neck, Cancer Center, Sun Yat sen University were surveyed. The treatment modalities were classified into two groups: simple radiotherapy and multimodality (surgery operation plus postoperational radiotherapy). The 3 year and 5 year survival rates of the two groups were analyzed. The different local lymph nodes metastasis was explored at the same time. RESULTS: Both the 3 year and 5 year survival rates of the simple radiotherapy group (35.2%and 17.6%) were lower than another group (59.1%and 45.5%) with significant difference (P< 0.05). Of 39 follow up patients, 18 were found with neck lymph node metastasis. Contralateral or (and) bilateral lymph node metastasis were found in 72.7%(13/18) of the patients with neck lymph node metastasis. CONCLUSION: Multimodality is an effective method for inferior postcricoid carcinoma. It will increase the survival rate of the inferior postcricoid carcinoma by paying more attention to contralateral or (and) bilateral lymph node metastasis and dealing with it actively.