南方医科大学学报

南方医科大学学报 ›› 2022, Vol. 42 ›› Issue (8): 1230-1236.doi: 10.12122/j.issn.1673-4254.2022.08.16

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治疗方式对中晚期人乳头状瘤病毒阴性口咽癌患者的生存率和生存质量的影响

李建成，郭 蕴，崔文静，孙 悦，杨东昆，刘 亮，吴志刚   

  1. 蚌埠医学院第一附属医院 口腔颌面外科，安徽 蚌埠 233004
  • 出版日期:2022-08-20 发布日期:2022-09-05

Survival rate and quality of life of human papillomaviruse-negative patients with advanced oropharyngeal cancer receiving different treatments

LI Jiancheng, GUO Yun, CUI Wenjing, SUN Yue, YANG Dongkun, LIU Liang, WU Zhigang   

  1. Department of Oral and Maxillofacial Surgery, First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, China
  • Online:2022-08-20 Published:2022-09-05

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摘要： 目的 探讨中晚期人乳头状瘤病毒阴性口咽癌治疗方式和方法的改变对患者生存率和生存质量状况的影响，为口咽癌的治疗提供合适的治疗方案。方法 回顾分析我院2015年1月~2020年12月住院的口咽癌患者，通过病例分析及影像学资料、病理资料补充，共筛选出符合纳入和排除标准的405例患者，建立患者个人治疗资料信息库，按治疗方式对研究对象分类；通过随访采用Kaplan-meier、Log-rank计算和对比分析总生存率以及各种治疗方式的生存率；通过UW-QOL（4）问卷对无瘤生存者行生存质量自评，并通过统计学分析比较各种治疗方式的生存质量。结果 该研究对象按治疗方式共分为3类：化疗+手术+放疗（CSRT）146例、手术+放疗（SRT）138例、放疗+化疗（RCT）121例。1、3、5年的总体生存率85.1%、67.1%、56.9%，CSRT、SRT、RCT三种治疗方式生存率无统计学意义（P>0.05）。共发放UW-QOL（4）问卷280份，实收202份，回收率为72.14%，3种治疗方式生存质量问卷平均总分值比较顺序CSRT>SRT>RCT，统计学分析CSRT与SRT、RCT之间有统计学意义（P<0.05），但SRT与RCT无统计学意义（P>0.05）。结论 CSRT、SRT、RCT均可作为局部中晚期口咽癌治疗方式的选择，CSRT较SRT、RCT有较好的患者治疗后生存质量。

关键词: 口咽癌；生存率；生存质量；治疗方式；人乳头状瘤病毒

Abstract: Objective To analyze the survival rates and quality of life of human papillomaviruse (HPV)-negative patients with advanced oropharyngeal cancer after different combined treatments with chemotherapy, surgery and radiotherapy. Methods We retrospectively analyzed the data of patients with oropharyngeal cancer hospitalized in our hospital from January, 2015 to December, 2020, and after case analysis of the clinical, imaging and pathological data, 405 patients were included in this study and grouped according to the treatments they received. Kaplan-Meier and Log-rank analysis were used to calculate the overall survival rate and the survival rate of patients with different treatments. The self-rated quality of life of the tumor-free survivors was assessed using UW-QOL (4) questionnaire and compared among the patients with different treatments. Results Among the 405 patients included in this study, 146 received treatments with chemotherapy+surgery+radiotherapy (CSRT), 138 received surgery+radiotherapy (SRT) and 121 were treated with radiotherapy+chemotherapy (RCT). The overall survival rates of the 3 groups at 1, 3 and 5 years were 85.1%,67.1% and 56.9%, respectively, and the survival rates of patients receiving CSRT, SRT and RCT did not differ significantly (P>0.05). A total of 280 UW-QOL (4) questionnaires were distributed and 202 (72.14%) were retrieved. The average total scores decreased in the order of CSRT>SRT>RCT; the scores were significantly higher in CSRT group than in SRT and RCT (P<0.05), but did not differ significantly between SRT and RCT groups (P>0.05). Conclusion CSRT, SRT and RCT are all treatment options for locally advanced oropharyngeal cancer, but CSRT may achieve better quality of life of the patients than SRT and RCT.

Key words: oropharyngeal cancer; survival rate; quality of life; treatment; human papillomaviruse