中药清瘤亮喉方辅助治疗喉咽癌的临床观察

作者	单位
陈万军	山东省医学科学院,山东省肿瘤医院头颈科
汪冰	山东中医药大学附属医院耳鼻喉科
韩秀丽	山东中医药大学附属医院耳鼻喉科

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中文摘要:

目的探讨中药清瘤亮喉方在喉咽癌综合治疗中的辅助作用。方法喉咽鳞状细胞癌患者 156例,其中Ⅰ期 21 例、Ⅱ期 34 例、Ⅲ期 55 例、Ⅳ期 46 例; 行手术加放疗( 简称 A 组) 31 例,手术加放疗加中药清瘤亮喉方( 简称 B 组) 40 例,放疗加化疗( 简称 C 组) 45 例,放疗加化疗加中药清瘤亮喉方( 简称 D 组) 40例。中药疗程均为 12 周。观察各组放、化疗毒性反应、生活质量评分( KPS 评分) 及远期疗效( 复发及生存时间) 。结果 B 组较 A 组毒性反应分级降低,表现在放射性皮炎、口腔黏膜炎、吞咽困难、体重变化、颈部淋巴水肿方面( P <0. 05,P <0. 01) ; D 组较 C 组毒性反应分级显著降低,主要表现在放射性皮炎、口腔黏膜炎、吞咽困难、骨髓抑制、消化道反应、体重变化方面( P < 0. 05,P < 0. 01) 。所有患者治疗后 KPS 评分均降低( P <0. 05,P <0. 01) ,但 B 组患者 KPS 评分高于 A 组患者( P <0. 05) ,D 组高于 C 组( P <0. 05) 。A 组患者3 年复发率及5 年生存率分别为41. 94%及38. 71%,B 组分别为20. 00%及62. 50%( P <0. 05) ; C 组分别为 60. 00%及 22. 22%,D 组分别为 37. 50%及 42. 50%( P <0. 05) 。结论清瘤亮喉方能有效地预防和减轻手术、放疗、化疗的毒性反应,结合手术、放疗、化疗治疗喉咽癌可降低肿瘤复发率,延长患者的寿命。其对喉咽癌的辅助治疗作用不容忽视。

英文摘要:

Objective To study the adjunctive roles of Qingliu Lianghou Recipe(QLR) in treatment of hypopharyngeal carcinoma.Methods A total of 156 patients with hypopharyngeal squamous cell carcinoma were recruited,including 21 cases of stage Ⅰ,34 in stage Ⅱ,55 in stage Ⅲ,and 46 in stage Ⅳ.Of them,31 patients(Group A) were managed with operation and post-operative radiotherapy,40 patients(Group B) with operation,post-operative radiotherapy,and QLR,45 patients(Group C) were managed with concomitant chemoradiotherapy,40 patients(Group D)with concomitant chemoradiation and QLR.QLR was given for 12 weeks.The radio-and chemicotoxic reactions,quality of life(KPS score),and long-term efficacy(the recurrence time and the survival time) were observed.Results The toxicity levels were significantly lower in Group B than in Group A,manifested as radioactive dermatitis,mucositis,dysphagia,changes in body weight,and lymphatic edema(P<0.05,P<0.01).The toxicity levels were significantly lower in Group D than in Group C,manifested as radioactive dermatitis,mucositis,dysphagia,marrow depression,changes in body weight,and gastrointestinal reactions(P<0.05,P<0.01).After treatment the KPS scores of all patients obviously decreased(P<0.05,P<0.01).But the KPS scores were significantly higher in Group B than in Group A(P<0.05),and they were significantly higher in Group D than in Group C(P<0.05).The 3-year recurrence rate of patients in Group A was 41.94%,20.00% in Group B,60.00% in Group C,and 37.50% in Group D(P<0.05).The 5-year survival rate of patients in Group A was 38.71%,62.50% in Group B,22.22% in Group C,and 42.50% in Group D(P<0.05).Conclusions QLR could effectively prevent and reduce the toxicity response caused by operation,radiotherapy and chemotherapy.The combination therapy of integrative medicine could postpone the recurrence and prolong the lifespan of patients.Therefore,we must not neglect the adjunctive therapy of QLR in treating hypopharyngeal carcinoma.

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