|本期目录/Table of Contents|

[1]朱骏,彭国林,吴文清,等.小剂量顺铂化疗联合喉部分切除术治疗喉癌效果分析及对患者甲状腺功能的影响[J].医学研究与战创伤救治(原医学研究生学报),2019,21(4):369-373.[doi:10.3969/j.issn.1672-271X.2019.04.008]
 ZHU Jun,PENG Guo-lin,WU Wen-qing,et al.Effect of low-dose cisplatin chemotherapy combined with partial laryngectomy on laryngeal carcinoma and its influence on thyroid function[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2019,21(4):369-373.[doi:10.3969/j.issn.1672-271X.2019.04.008]
点击复制

小剂量顺铂化疗联合喉部分切除术治疗喉癌效果分析及对患者甲状腺功能的影响()

《医学研究与战创伤救治》(原医学研究生学报)[ISSN:1672-271X/CN:32-1713/R]

卷:
第21卷
期数:
2019年4期
页码:
369-373
栏目:
临床研究
出版日期:
2019-07-20

文章信息/Info

Title:
Effect of low-dose cisplatin chemotherapy combined with partial laryngectomy on laryngeal carcinoma and its influence on thyroid function
文章编号:
1672-271X(2019)04-0369-05
作者:
朱骏 彭国林 吴文清 彭世义
作者单位:335000 鹰潭,解放军联勤保障部队第九○八医院肿瘤科(朱 骏、彭国林、吴文清);330000 南昌,江西省肿瘤医院放二科(彭世义)
Author(s):
ZHU Jun12 PENG Guo-lin12 WU Wen-qing12 PENG Shi-yi12
(1.Department of Oncology,the 908th Hospital of the Joint Logistics Support Force,PLA,Yingtan 335000,Jiangxi,China; 2.Department of Radiotherapy,Jiangxi Cancer Hospital,Nanchang 330000,Jiangxi,China)
关键词:
喉癌 喉部分切除术 小剂量顺铂化疗 甲状腺功能 远期生存率 肿瘤细胞凋亡率
Keywords:
laryngeal cancer partial laryngectomy low dose cisplatin chemotherapy thyroid function long term survival rate tumor cell apoptosis rate
分类号:
R739.65
DOI:
10.3969/j.issn.1672-271X.2019.04.008
文献标志码:
A
摘要:
目的 探讨小剂量顺铂化疗联合喉部分切除术治疗喉癌的疗效分析及对患者甲状腺功能的影响。 方法 回顾性分析2012年1月至2013年5月解放军联勤保障部队第九○八医院和江西省肿瘤医院收治的喉癌患者102例的临床资料,根据治疗方法不同,将患者分成对照组51例(应用喉部分切除术治疗)、喉切除联合化疗组51例[喉部分切除联合应用小剂量(50 mg/m2)顺铂化疗]。观察对比2组喉癌患者的疾病控制率及缓解率、5年生存率、治疗前及治疗后的甲状腺功能变化情况[促甲状腺激素(TSH)、血清总三碘甲腺原氨酸(T3)及血清总四碘甲腺原氨酸(T4)]、治疗后的不良反应发生情况及患者体内肿瘤细胞的凋亡率。 结果 喉切除联合化疗组患者经治疗后总的疾病控制率为92.2%、疾病缓解率为64.7%,对照组分别为78.4%、47.1%,喉切除联合化疗组患者的临床疗效显著高于对照组(P<0.05)。喉切除联合化疗组患者的5年总生存率为显著高于对照组(86.3% vs 56.9%,P<0.05)。治疗后,喉切除联合化疗组患者的TSH水平为(2.61±0.61)nmol/L,显著高于对照组患者的(1.79±0.48)nmol/L(P<0.05);喉切除联合化疗组患者血清T3、T4水平为(4.09±0.44)nmol/L、(16.17±2.27)μIU/L,显著低于对照组患者的(5.46±0.52)nmol/L、(17.68±2.15)μIU/L(P<0.05)。喉切除联合化疗组患者的Ⅲ级及Ⅳ级不良反应发生率显著低于对照组(25.5% vs 56.9%,P<0.05)。喉切除联合化疗组患者体内的肿瘤细胞凋亡率显著高于对照组[(29.32±2.63)% vs (20.97±1.69)%,P<0.05]。 结论 对喉癌患者应用小剂量顺铂联合喉部分切除术,能提高患者体内肿瘤细胞的凋亡率,疗效更显著。但须严格监控患者的T3、T4及TSH的指标水平,以免出现全身性代谢减低综合征。
Abstract:
Objective To investigate the efficacy analysis of low-dose cisplatin chemotherapy combined with partial laryngectomy in the treatment of laryngeal cancer and the effect on thyroid function of patients. Methods A retrospective analysis from January 2012 to May 2013,the people’s liberation army logistic support forces result 9 and jiangxi province tumor hospital of the clinical data of 102 cases of laryngeal cancer patients admitted in the hospital. According to different treatment methods, the patients were divided into control group (51 cases treated with partial laryngectomy) and laryngectomy combined with chemotherapy group [51 cases treated with partial laryngectomy combined with low dose (50 mg/m2) of cisplatin]..Observed and compared two groups of patients with laryngeal cancer disease control rate and remission rate,5-year survival rate,changes before and after the treatment of thyroid function [thyroid-stimulating hormone (TSH),serum total three iodine armour gland original glycine (T3) and serum total four iodine a gland glycine (T4)],adverse reactions occurred after treatment,and patients with tumor cell apoptosis rate in the body. Results The total disease control rate and remission rate of laryngectomy combined with chemotherapy group were 92.2% and 64.7% respectively. The control group was 78.4% and 47.1% respectively.The clinical efficacy of patients in the laryngectomy combined with chemotherapy group was significantly higher than that in the control group (P<0.05).The 5-year overall survival rate of patients in the laryngectomy combined with chemotherapy group was 86.3%,significantly higher than that of the control group (86.3% vs 56.9%,P<0.05). After treatment, the TSH level in laryngectomy combined with chemotherapy group was (2.61±0.61) nmol/L, significantly higher than control group in patients with TSH level (1.79±0.48) nmol/L (P<0.05),serum total laryngectomy combined chemotherapy group patients T3 and T4 level (4.09±0.44) nmol/L,(16.17±2.27) μIU/L,The level of T3/T4 was significantly lower than that of control group (5.46±0.52) nmol/L and (17.68±2.15) μIU/L (P<0.05).Laryngectomy in combination with chemotherapy group Ⅲ level and Ⅳ level in patients with the incidence of adverse reactions was significantly lower than the control group patients Ⅲ level and grade Ⅳ incidence by 56.9% (25.5% vs 56.9%,P<0.05).The apoptosis rate of tumor cells in the laryngectomy combined with chemotherapy group was significantly higher than that in the control group [(29.32±2.63)% vs (20.97±1.69)%,P<0.05]. Conclusion Low dose cisplatin combined with partial laryngectomy is more effective in the treatment of laryngeal cancer patients,and can improve the apoptosis rate of tumor cells in patients.However,the index levels of T3,T4 and TSH should be strictly monitored to avoid the occurrence of systemic metabolic reduction syndrome.

参考文献/References:

1 黄岸坤,黄少波,廖艳萍.喉部分切除术治疗喉癌的疗效及影响因素分析[J].海南医学,2016,27(12):1965-1967.
2 折素珍,王斌全.CO2激光在喉癌治疗中的应用[J].国际耳鼻咽喉头颈外科杂志,2016,40(1):44-47.
3 ZengYC,XingR,ZengJ,et al.Sodium glycididazole enhances the radiosensitivity of laryngeal cancer cells through downregulation of ATM signaling pathway[J].Tumor Biol,2016,37(5):5869-5878.
4 黄冠江,刘红兵,张靖萱,等.经口机器人手术在喉癌外科治疗中的应用进展[J].临床耳鼻咽喉头颈外科杂志,2016,22(21):1744-1746.
5 陶振峰,申宇鹏.早期喉癌微创治疗研究进展[J].解放军医药杂志,2017,29(11):114-116.
6 ZhouS,ShenY,MinZ,et al.DNA methylation of METTL7A gene body regulates its transcriptional level in thyroid cancer[J].Oncotarget,2017,8(21):34652-34660.
7 葛文洁,江浩.同步放化疗在局部晚期喉癌治疗中的研究进展[J].安徽医学,2017,38(4):523-526.
8 胡慧英,于振坤,何双八,等.HPV感染在咽喉部鳞癌及喉乳头状瘤中的分布研究[J].医学研究生学报,2017,30(12):1264-1267.
9 洪朝欣,罗丹凤,陈秋桂,等.手术联合放射治疗与单纯喉部分切除术治疗喉癌的临床对照研究[J].实用癌症杂志,2018,14(2):221-223.
10 ShivappaN,HébertJR,RosatoV,et al.Inflammatory potential of diet and risk of laryngeal cancer in a case-control study from Italy[J].Cancer Causes Control,2016,27(8):1027-1034.
11 王慧敏,余文发,周航,等.微创切除术联合低剂量放疗对早期喉癌治疗效果的研究[J].癌症进展,2017,15(3):287-289.
12 张小英,蔡云霞,温平,等.改良手术体位对喉癌根治术后病人舒适度的影响[J].全科护理,2017,15(17):2132-2133.
13 MohamedAS,PhamBH,MesserJA,et al.Identification of Anatomic Correlates of Failure in Patients With T4a Larynx Cancer[J].Int J Radiat Oncol,2016,94(4):896-896.
14 郑伟昌,张巧真,蒋慈英,等.低温等离子消融术治疗早期声门型喉癌的疗效分析[J].中华全科医学,2016,14(4):561-562.
15 JacksonMW,AminiA,JonesB,et al.Improved Survival With 3DCRT Over IMRT in Early-Stage Larynx Cancer:A National Cancer Data Base Analysis[J].Int J Radiat Oncol,2016,94(4):872-873.
16 侯素平,赵娟霞,杨丽娟,等.miR-1264对喉癌Hep2细胞增殖和迁移的影响[J].医学研究生学报,2018,31(3):273-278.
17 杨少峰,龚继涛,郑海民,等.低温等离子刀联合小剂量放疗治疗早期喉癌的近期疗效及安全性[J].实用癌症杂志,2017,32(5):751-753.

相似文献/References:

备注/Memo

备注/Memo:
收稿日期:2018-08-03
更新日期/Last Update: 2019-07-11