| Objectives: To summarize the clinical effect of neoadjuvant chemotherapy in patients with advanced laryngopharyngeal carcinoma in our hospital,and to explore the significance of different treatment strategies in the treatment of advanced laryngopharyngeal carcinoma.Methods: The clinical data of patients with advanced hypopharyngeal carcinoma surgically treated in our hospital from January 2010 to April 2017 were retrospectively analyzed.73 cases were included,and was divided into two groups.28 patients in the surgery plus radiotherapy group,and 45 patients in the neoadjuvant chemotherapy,surgery plus radiotherapy group,and evaluate the efficacy of neoadjuvant chemotherapy.Observed and compared the two groups of patients preserved throat rate,postoperative pronunciation,swallowing function,occurrence of pharyngeal fistula,resection margin,and local recurrence rate,survival rate.Statistical analysis was performed using Spss17.0 statistical software.Chi-square test was used for count data,rank sum test was used for rank data,survival rate was calculated by Kaplan-meire method and Log-rank test was used.P <0.05 was considered statistically significant.Results: 1.Evaluation of the efficacy of neoadjuvant chemotherapy: After neoadjuvant chemotherapy,the primary tumor and neck metastases were reduced in size,including 2 CR(4.4%),29 PR(64.5%),15 NC(28.9%),and 1 PD(2.2%),33 cases(68.9%)were effective.Two of the three patients with stage III hypopharyngeal cancer were relegated to stage I and stage 0 after chemotherapy,and three cases of stage IVA patients were degraded to stage III after PR.2.Keeping the throat rate: 80%(36/45)in the chemotherapy,surgery plus radiotherapy group and 50% in the surgery plus radiotherapy group.(14/28),there was a statistically significant difference between the two groups(P <0.05).3.Swallowing function: 35.58 mean score in chemotherapy,surgery plus radiotherapy group and 39.29 in surgery plus radiotherapy group.The swallowing function difference between the two groups was no statistically significantce.(P >0.05).4.Pronunciation function: 32.96 mean score in chemotherapy,surgery plus radiotherapy group and 43.50 in surgery plus radiotherapy group,the pronunciation function of the experimental group was better than the control group(P < 0.05);5.Pharyngeal fistula: 11 cases(24.4%)in the chemotherapy,surgery plus radiotherapy group and 6 cases(21.4%)in the surgery plus radiotherapy group(P >0.05).6.Resection margin: positive margin: 4 cases(8.9%)in the chemotherapy,surgery plus radiotherapy group and 4 cases(14.3%)in the surgery plus radiotherapy group(P >0.05);Severe dysplasia at the margin: 5 cases in the chemotherapy,surgery plus radiotherapy group(11.1%),surgery plus radiotherapy group 2 cases(7.2%)(P > 0.05);7.Local recurrence rate: local recurrence rate in half year: 4.8% in chemotherapy,surgery plus radiotherapy group and 3.8% in surgery plus radiotherapy group(P >0.05);local recurrence rate in one year: 11.9% in experimental group;11.5% in surgery plus radiotherapy group(P >0.05).8.Survival rate: The 1-year,2-year,and 3-year survival rates of the surgery plus radiotherapy group were 85.8%,69.5%,and 54.2%,respectively.The 1-,2-,and 3-year survival rates of the chemotherapy,surgery plus radiotherapy group were 86.2%,69.9%,and 56.3 respectively.%,It shows no significant difference in survival rate between the two groups(P >0.05).Conclusions: 1.The short-term efficacy of neoadjuvant chemotherapy is worthy of recognition.It can reduce the size of tumor primary tumors and metastases and reduce the tumor stage.2.It is safe and reliable to remove the tumor according to the narrowed tumor range after neoadjuvant chemotherapy,without increasing the positive rate of the margin and dysplasia,and no significant effect on the local recurrence rate;3.Neoadjuvant chemotherapy can improve the preservation rate of laryngeal function in patients with advanced hypopharyngeal carcinoma,improve the postoperative function of patients,improve the quality of life of patients,but no significant effect on swallowing function;4.Neoadjuvant chemotherapy does not increase postoperative pharyngeal fistula complications;5.Neoadjuvant chemotherapy has no obvious benefit for long-term survival. |
PDF Full Text Request