小剂量化疗联合术后放疗对Ⅲ期和Ⅳ期口腔癌患者预后的影响及相关因素分析

doi:10.3969/j.issn.1006-6233.2024.10.020

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摘要 目的:观察小剂量化疗联合术后放疗对Ⅲ~Ⅳ期口腔癌患者预后的影响,并分析影响预后的相关因素。方法:选取2019年1月至2022年5月我院收治的90例Ⅲ~Ⅳ期口腔癌患者,按照简单随机分组法将其分为对照组和联合组,对照组(n=45)术后给予放疗,联合组(n=45)给予术前小剂量化疗联合术后放疗,对比两组临床疗效,统计并对比两组2年复发率。根据患者术后2年复发情况将其分为复发组与未复发组,采用多因素Logistic回归分析患者预后的影响因素。结果:联合组疾病控制率(DCR)高于对照组(P<0.05);随访2年,联合组有3例患者失访,对照组有4例患者失访。完成随访的83例患者中有39例复发,总复发率为46.99%(39/83)。联合组患者复发率为40.48%(17/42),与对照组的53.66%(22/41)比较差异无统计学意义(P>0.05)。复发组pN分期、病理分化程度、淋巴结比率、神经侵犯与未复发组比较差异有统计学意义(P<0.05)。多因素分析显示,pN分期、淋巴结比率、神经侵犯是Ⅲ~Ⅳ期口腔癌患者术后复发的影响因素(P<0.05)。结论:小剂量化疗联合术后放疗可以提高Ⅲ~Ⅳ期口腔癌患者临床疗效,但在改善患者预后方面尚无明显优势,患者预后相关影响因素包括pN分期、淋巴结比率、神经侵犯。

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	朱凌
	杜若鸿
	后军

关键词 ：口腔癌, 化疗, 放疗, 预后, 影响因素

Abstract：Objective: To observe the impact of low-dose chemotherapy combined with postoperative radiotherapy on the prognosis of patients with stage Ⅲ-Ⅳ oral cancer and to analyze the factors affecting prognosis. Methods: A total of 90 patients with stage Ⅲ~Ⅳ oral cancer, treated at our hospital between January 2019 and May 2022, were selected and randomly divided into two groups: the control group (n=45) received postoperative radiotherapy, and the combined group (n=45) received low-dose preoperative chemotherapy combined with postoperative radiotherapy. Clinical efficacy and the 2-year recurrence rates were compared between the two groups. Based on the patients' 2-year postoperative recurrence status, they were divided into the recurrence group and the non-recurrence group, and a multivariate logistic regression analysis was conducted to identify factors influencing prognosis. Results: The disease control rate (DCR) of the combined group was significantly higher than that of the control group (P<0.05). After a 2-year follow-up, 3 patients from the combined group and 4 from the control group were lost to follow-up. Among the 83 patients who completed follow-up, 39 experienced recurrence, with an overall recurrence rate of 46.99% (39/83). The recurrence rate in the combined group was 40.48% (17/42), compared to 53.66% (22/41) in the control group, with no statistically significant difference between the two groups (P>0.05). Significant differences were observed between the recurrence and non-recurrence groups in terms of pN stage, pathological differentiation, lymph node ratio, and nerve invasion (P<0.05). Multivariate analysis showed that pN stage, lymph node ratio, and nerve invasion were influencing factors for postoperative recurrence in patients with stage Ⅲ-Ⅳ oral cancer (P<0.05). Conclusion: Low-dose chemotherapy combined with postoperative radiotherapy improves clinical efficacy in patients with stage Ⅲ-Ⅳ oral cancer, but has no significant advantage in improving prognosis. Prognosis-related factors include pN stage, lymph node ratio, and nerve invasion.

Key words： Oral cancer Chemotherapy Radiotherapy Prognosis Influencing factors

基金资助:2020年度安徽省自然科学基金项目,(编号:2008085QH375)

引用本文:

朱凌, 杜若鸿, 后军. 小剂量化疗联合术后放疗对Ⅲ期和Ⅳ期口腔癌患者预后的影响及相关因素分析[J]. 河北医学, 2024, 30(10): 1690-1694.
ZHU Ling, DU Ruohong, HOU Jun. Impact of Low-Dose Chemotherapy Combined with Postoperative Radiotherapy on the Prognosis of Stage Ⅲ Ⅳ Oral Cancer Patients and Analysis of Related Factors. HeBei Med, 2024, 30(10): 1690-1694.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2024.10.020 或 http://www.hbyxzzs.cn/CN/Y2024/V30/I10/1690

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