2种治疗方式治疗中晚期口腔癌的生存分析

    Survival analysis of two therapeutic modalities in the treatment of mid-late oral cancer

    • 摘要:
      目的 探讨中晚期口腔癌以手术治疗为主要治疗方式和以根治性放射治疗为主要治疗方式对病人生存率和生存质量的影响。
      方法 回顾分析三家省三甲综合性医院2015-2020年收治口腔癌病人资料,通过影像、病理资料和随访结果完善病人信息,按纳入和排除标准共筛选出中晚期口腔癌病人1 123例,按照首选治疗方法根治性手术治疗(ST组)和根治性放疗(RT组)2种治疗方式对筛选对象进行分组,采用Kaplan-Meier、Log-rank计算和比较分析总生存率及2种治疗方式的生存率;采用UW-QOL(4)问卷对无瘤生存者行生存质量自评,采用统计学分析比较2种治疗方式的生存率和生存质量。
      结果 病人1、3、5年总的生存率分别为84.0%、66.4%、54.0%;ST组757例,RT组366例,ST组生存率明显高于RT组(P < 0.05)。2组收回问卷生存质量平均总分值比较,ST组明显高于RT组(P < 0.05)。
      结论 以根治性手术治疗为主要治疗方式,术前诱导化疗术后低放射量放疗或术后辅助化疗,较以根治性放疗为主要治疗方式有较好的生存率和生存质量。中晚期口腔癌治疗方式的选择首选应以手术治疗为主术前/术后辅助低能化疗/放疗。

       

      Abstract:
      Objective To explore the impact of surgical treatment as the main treatment method and radical radiotherapy as the main treatment on the survival rate and quality of life of patients with mid-late oral cancer.
      Methods A retrospective analysis was conducted on the data of oral cancer patients admitted to three tertiary comprehensive hospitals in the province from 2015 to 2020.Patient information was improved through imaging, pathological data, and follow-up results.A total of 1 123 patients with mid-late oral cancer were screened according to inclusion and exclusion criteria.The screening subjects were divided into radical surgical treatment group (ST group) and radical radiotherapy group (RT group).Kaplan-Meier and Log-rank were used to calculate and compare overall survival rate and survival rate of two treatment methods.A UW-QOL (4) questionnaire was used to self-evaluate the quality of life of tumor free survivors, and statistical analysis was used to compare the survival rate and quality of life of two treatment methods.
      Results The overall survival rates of patients at 1, 3, and 5 years were 84.0%, 66.4%, and 54.0%, respectively.There were 757 cases in the ST group and 366 cases in the RT group, and the survival rate of ST group was significantly higher than that of the RT group (P < 0.05).The average total score of quality of life in the ST group was significantly higher than that in the RT group (P < 0.05) between the two groups who received questionnaires.
      Conclusions Radical surgery as the main treatment method, preoperative induction chemotherapy, postoperative low-dose radiotherapy, or postoperative adjuvant chemotherapy have better survival rates and quality of life compared to radical radiotherapy as the main treatment method.The first choice for the treatment of mid-late oral cancer should be surgical treatment as the main approach, with preoperative/postoperative adjuvant low-energy chemotherapy/radiotherapy.

       

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