螺旋断层放疗联合TPF诱导化疗治疗局部晚期口咽癌的疗效及其影响因素Logistic分析

doi:10.13701/j.cnki.kqyxyj.2021.07.014

口腔医学研究 ›› 2021, Vol. 37 ›› Issue (7): 641-645.DOI: 10.13701/j.cnki.kqyxyj.2021.07.014

• 口腔肿瘤与口腔影像学研究 • 上一篇下一篇

螺旋断层放疗联合TPF诱导化疗治疗局部晚期口咽癌的疗效及其影响因素Logistic分析

姜翠红^*, 吴湘玮, 肖帅, 贺礼理

湖南省肿瘤医院/中南大学湘雅医学院附属肿瘤医院头颈放疗一科湖南长沙 410013

收稿日期:2021-01-27 出版日期:2021-07-28 发布日期:2021-07-13
通讯作者: * 姜翠红,E-mail:jch056324078@163.com
作者简介:姜翠红(1980~ ),女,湖南邵东人,副主任医师,硕士,研究方向:肿瘤放射治疗。
基金资助:
湖南省卫生计生委科研计划课题项目(编号:C2017043)

Efficacy of Spiral Tomographic Radiotherapy Combined with TPF Induction Chemotherapy for Locally Advanced Oropharyngeal Cancer and Logistic Regression of Its Influencing Factors

JIANG Cuihong^*, WU Xiangwei, XIAO Shuai, HE Lili

Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410013, China

Received:2021-01-27 Online:2021-07-28 Published:2021-07-13

摘要/Abstract

摘要： 目的:探讨螺旋断层放疗联合TPF诱导化疗(多西他赛+顺铂+5-氟尿嘧啶)治疗局部晚期口咽癌的疗效及其影响因素Logistic回归方程分析。方法:选取2015年1月~2017年10月我院56例采用螺旋断层放疗联合TPF化疗治疗的局部晚期口咽癌患者的临床资料,开展回顾性研究,统计观察56例患者的近期疗效、远期疗效、毒副反应发生情况,并采用多因素Logistic、Cox分析近远期疗效影响因素。结果:螺旋断层放疗联合TPF化疗治疗局部晚期口咽癌患者的客观缓解率(ORR)为53.57%,1、3、5年生存率分别为83.93%、64.29%、39.29%;单因素分析显示,不同年龄、临床分期、分化程度局部晚期口咽癌患者的ORR、5年生存率对比,差异有统计学意义(P＜0.05);多因素分析显示,随着年龄、临床分期增加及分化程度降低,局部晚期口咽癌患者的近远期疗效逐渐降低(P＜0.05);治疗期间白细胞下降≥Ⅲ级发生率为21.43%,血小板下降≥Ⅲ级发生率为1.79%,口腔黏膜炎≥Ⅲ级发生率为7.14%,放射性皮炎≥Ⅲ级发生率为8.93%。结论:螺旋断层放疗联合TPF化疗治疗局部晚期口咽癌的疗效良好,毒副反应大多在可耐受范围内,年龄、临床分期、分化程度是其近远期疗效的影响因素,临床应给予足够重视。

关键词: 局部晚期口咽癌, 螺旋断层放疗, TPF化疗, 疗效, 影响因素, 毒副反应

Abstract: Objective: To investigate the efficacy of spiral tomographic radiotherapy combined with TPF induction chemotherapy (docetaxel + cisplatin + 5-fluorouracil) in the treatment of locally advanced oropharyngeal cancer and logistic regression equation analysis of its influencing factors. Methods: The clinical data of 56 patients with locally advanced oropharyngeal cancer treated with spiral tomographic radiotherapy combined with TPF chemotherapy in our hospital from January 2015 to Oct 2017 were selected and retrospectively studied. The short-term curative effect, long-term curative effect, and the occurrence of toxic and side effects of 56 patients were statistically observed, and the factors affecting the short-term and long-term curative effect were analyzed by multivariate Logistic and Cox. Results: The ORR of spiral tomographic radiotherapy combined with TPF chemotherapy for locally advanced oropharyngeal cancer patients was 53.57%, and the 1, 3, and 5-year survival rates were 83.93%, 64.29%, and 39.29%, respectively. Univariate analysis showed that the ORR and 5-year survival rate of patients with locally advanced oropharyngeal cancer of different ages, clinical stages, and degree of differentiation were statistically significant (P<0.05). Multivariate analysis showed that with the increase of age, clinical stage, and degree of differentiation, the short-term and long-term efficacy of locally advanced oropharyngeal cancer patients gradually decreased (P<0.05). During the treatment, the incidence of white blood cell decline ≥ grade Ⅲ was 21.43%, the incidence of platelet decline ≥ grade Ⅲ was 1.79%, the incidence of oral mucositis ≥ grade Ⅲ was 7.14%, and the incidence of radiation dermatitis ≥ grade Ⅲ was 8.93%. Conclusion: Spiral tomographic radiotherapy combined with TPF chemotherapy is effective in the treatment of locally advanced oropharyngeal cancer. The toxic and side effects are mostly within the tolerable range. Age, clinical stage, and degree of differentiation are influencing factors for its short-term and long-term efficacy, and sufficient clinical attention should be paid.

Key words: locally advanced oropharyngeal cancer, spiral tomographic radiotherapy, TPF chemotherapy, curative effect, influencing factors, toxic and side effects

姜翠红, 吴湘玮, 肖帅, 贺礼理. 螺旋断层放疗联合TPF诱导化疗治疗局部晚期口咽癌的疗效及其影响因素Logistic分析[J]. 口腔医学研究, 2021, 37(7): 641-645.

JIANG Cuihong, WU Xiangwei, XIAO Shuai, HE Lili. Efficacy of Spiral Tomographic Radiotherapy Combined with TPF Induction Chemotherapy for Locally Advanced Oropharyngeal Cancer and Logistic Regression of Its Influencing Factors[J]. Journal of Oral Science Research, 2021, 37(7): 641-645.

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螺旋断层放疗联合TPF诱导化疗治疗局部晚期口咽癌的疗效及其影响因素Logistic分析

Efficacy of Spiral Tomographic Radiotherapy Combined with TPF Induction Chemotherapy for Locally Advanced Oropharyngeal Cancer and Logistic Regression of Its Influencing Factors

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