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目的分析以喉癌为首发癌的多原发癌的发病部位、治疗效果及生存状况,探讨喉癌多原发癌临床诊治要点。方法回顾性分析42例以喉癌为首发癌的多原发癌的临床资料,探讨临床疗效影响因素,总结各自临床诊治特点。结果 42例患者中,多原发癌发生在头颈部位的有22例(52.4%)、发生在非头颈部位的有20例(47.6%)。喉癌多原发癌3、5年生存率分别为47.6%(20/42)、26.2%(11/42)。经过积极治疗的多原发癌的3、5年生存率为56.3%(18/32)、34.4%(11/32),明显高于未予治疗的患者[20.0%(2/10)、0(0/10),P<0.01]。头颈部和非头颈部多原发癌患者的3、5年生存率无统计学差异。放疗患者头颈部多原发癌的发病率为77.3%,明显高于非放疗患者(45.0%,P<0.01)。喉癌的治疗方式与多原发癌预后无明显相关。结论喉癌多原发癌以肺癌及鼻咽癌最为常见;放疗患者易发生头颈部多原发癌,积极对第二原发癌进行治疗有利于患者预后。
Objective To analyze the incidence, survival and treatment of multiple primary cancers with laryngeal cancer as the first cancer and to explore the main points of clinical diagnosis and treatment of multiple primary laryngeal cancer. Methods A retrospective analysis of 42 cases of primary cancer of the laryngeal cancer of the clinical data to explore the impact of clinical factors, summarize their clinical diagnosis and treatment characteristics. Results Among the 42 patients, multiple primary cancers occurred in 22 cases (52.4%) in the head and neck area and in 20 cases (47.6%) in the non-head and neck area. The 3 and 5-year survival rates of multiple primary laryngeal cancer were 47.6% (20/42) and 26.2% (11/42), respectively. The 3- and 5-year survival rates of actively treated primary cancers were 56.3% (18/32) and 34.4% (11/32), respectively, which were significantly higher than those of untreated patients (20.0%, 2/10) and 0 (0/10), P <0.01]. There was no significant difference in the 3 and 5-year survival rates between patients with multiple primary cancers of head and neck and non-head and neck cancers. The incidence of multiple primary cancers in patients with radiotherapy was 77.3%, which was significantly higher than that of non-radiotherapy patients (45.0%, P <0.01). Laryngeal cancer treatment and prognosis of multiple primary no significant correlation. Conclusions Multiple primary carcinoma of the larynx is most common in lung cancer and nasopharyngeal carcinoma. Patients with radiotherapy are prone to multiple primary cancers of the head and neck. Positive treatment of the second primary carcinoma is beneficial to the prognosis of the patients.