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【medical-news】晚期喉癌行全喉切除术优于保守治
NEW YORK (Reuters Health) Jan 03 - Compared with combined chemo/radiotherapy, total laryngectomy improves survival in patients with stage IV laryngeal cancer, according to a report in the Archives of Otolaryngology--Head and Neck Surgery for December.
The results also show that black patients and those with Medicare or Medicaid insurance have inferior outcomes, which may be the result of limited access to care.
Dr. Amy Y. Chen from Emory University and Dr. Michael Halpern from the American Cancer Society, both in Atlanta, assessed factors predictive of survival in advanced laryngeal cancer by analyzing data from 7019 patients drawn from a national registry involving Commission on Cancer-approved treatment facilities.
In the overall analysis, survival was highest for patients treated with total laryngectomy than for those given chemo/radiotherapy or radiotherapy alone (p < 0.001). Compared with total laryngectomy, the hazard ratios for death were 1.6 with radiotherapy and 1.3 with chemo/radiotherapy.
Further analysis showed that total laryngectomy and chemo/radiotherapy provided comparable and better survival outcomes than radiotherapy alone for patients with stage III disease. For patients with stage IV disease, however, total laryngectomy was clearly superior to the other two treatments (p < 0.001).
Women were 12% more likely to survive during follow-up than were men (p = 0.002). Compared with whites, blacks were 14% more likely to die (p = 0.004). Relative to private insurance, Medicaid insurance was associated with a 57% increased mortality risk, while with Medicare mortality was increased by 30% to 35% depending on age.
Dr. Chen and Dr. Halpern note that the finding that total laryngectomy provides better survival than radiotherapy alone is consistent with previous research. By contrast, the finding in the overall analysis that total laryngectomy also achieves higher survival rates than chemo/radiotherapy runs counter to prior reports, which have generally shown equivalent results.
This "may reflect differences in patient mix between those enrolled in previous clinical trials (reporting equivalent survival following total laryngectomy and chemo/radiotherapy) and the broader population of patients with laryngeal cancer treated at Commission on Cancer facilities across the US," the authors suggest.
Arch Otolaryngol Head Neck Surg 2007;133:1270-1276.
http://www.medscape.com/viewarticle/568226 认领此文翻译，４８小时未交稿请其他战友认领～ NEW YORK (Reuters Health) Jan 03 - Compared with combined chemo/radiotherapy, total laryngectomy improves survival in patients with stage IV laryngeal cancer, according to a report in the Archives of Otolaryngology--Head and Neck Surgery for December.
纽约（路透社健康专栏）1月3日,根据《耳鼻喉头颈外科学文献》12月刊报道:与化/放疗比较,全喉切除术增加了IV期喉癌病人的生存率.
The results also show that black patients and those with Medicare or Medicaid insurance have inferior outcomes, which may be the result of limited access to care.
研究还表明黑色人种的病人及享受医疗保险和医疗补助的病人效果较差可能是因为受到医疗条件的限制.
Dr. Amy Y. Chen from Emory University and Dr. Michael Halpern from the American Cancer Society, both in Atlanta, assessed factors predictive of survival in advanced laryngeal cancer by analyzing data from 7019 patients drawn from a national registry involving Commission on Cancer-approved treatment facilities.
目前均在亚特兰大,来自Emory University 的Dr. Amy Y. Chen和来自American Cancer Society的Dr. Michael Halpern,通过分析7019个病人的数据以评估晚期喉癌病人的预期生存因素,这些病人均在一个美国注册的癌症治疗设备委员会接受治疗
In the overall analysis, survival was highest for patients treated with total laryngectomy than for those given chemo/radiotherapy or radiotherapy alone (p < 0.001). Compared with total laryngectomy, the hazard ratios for death were 1.6 with radiotherapy and 1.3 with chemo/radiotherapy.
经过全面的分析,全喉切除术后的病人的生存率远远高于仅仅使用放疗或化/放疗联合治疗的病人.(p < 0.001).单纯放疗的死亡率是全喉切除术的1.6 倍,而化/放疗联合治疗则是全喉切除术的1.3 倍.
Further analysis showed that total laryngectomy and chemo/radiotherapy provided comparable and better survival outcomes than radiotherapy alone for patients with stage III disease. For patients with stage IV disease, however, total laryngectomy was clearly superior to the other two treatments (p < 0.001).
进一步的研究指出对于III期的病人,全喉切除术和放/化疗联合治疗在提高生存率上比单纯的放疗仅稍有优势.但是对于IV期喉癌, 全喉切除术却显著优于其他两种方法. (p < 0.001).
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作者:admin@医学,生命科学 2011-07-14 11:20
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