東台灣鼻咽癌之治療經驗

Treatment of Nasopharyngeal Carcinoma in Eastern Taiwan

黃同村(Tung-Tsun Huang) ； 陳培榕(Peir-Rong Chen) ； 徐莉萍(Lee-Ping Hsu)

《慈濟醫學雜誌》 16卷3期 (2004/06) Pp. 159-165

https://doi.org/10.6440/TZUCMJ.200406.0159

摘要

目的：鼻咽癌為國人常見之惡性腫瘤。本研究藉由病例回溯性分析，回顧本院對東台灣鼻咽癌患者的治療成果。材料與方法：自1991年至2000年期間，診斷為鼻咽癌並於本院接受治療、追蹤的病患，累計共209例。追蹤日期至2002年12月止，並就各變項進行分析。結果：本研究顯示鼻咽癌患者初診斷時，多達62.7%已屬晚期，而且9.6%已有遠隔轉移。排除7名沒有遠隔轉移卻拒絕積極治療之病患，其餘病患整體五年存活率為51.4%。臨床分期及年齡對存活率有顯著影響，布農族患者之存活率明顯優於其他原住民種族。分析治療失敗病患之原因，原發處失敗及續發性遠隔轉移高達23.1%及22.0%。結論：應加強大眾教育，以期達到早期診斷、早期治療的目標。對於晚期鼻咽癌患者，除了同時併用化學及放射線治療以增加原發處控制率外，可嘗試加入誘導式化學治療，以期減少遠隔轉移失敗率。

關鍵字

鼻咽癌 ； 治療 ； 東台灣

並列摘要

Objective: Nasopharyngeal carcinoma (NPC) is a common malignancy in Taiwan. This retrospective study was conducted to review the treatment outcome of NPC patients in our hospital in eastern Taiwan. Materials and Methods: Two hundred and nine patients were diagnosed as suffering from NPC and underwent treatment at our hospital between 1991 and 2000. These cases were followed up until December 2002 and their survival was analyzed by various categories. Results: This study revealed 62.7% of these 209 patients belonged to the late-stage category of the disease on diagnosis with NPC, and 9.6% already had detectable distant metastasis. Excluding the 7 non-disseminated patients who refused aggressive treatment, the overall 5-year disease-specific survival rate was 51.4%. Clinical stage and age were found to be statistically significant prognostic factors. The Bunun tribe had the most favorable survival rate among Taiwanese aborigine groups. Primary site failure occurred in 23.1% of the patients who had non-disseminated NPC and completed treatment. Subsequent distant metastasis occurred in 22.0% of cases. Conclusions: We should educate the general public in eastern Taiwan in order to achieve a goal of early diagnosis and early treatment of this disease. In addition to undergoing concurrent chemoradiotherapy to obtain an improved locoregional control rate in advanced NPC patients, the addition of induction chemotherapy could be very useful to decrease distant metastatic rate.

並列關鍵字

nasopharyngeal carcinoma ； treatment ； eastern Taiwan