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Multiple Primary Cancers in NTUH Patients with Cancer of the Head and Neck
台大醫院頭頸部腫瘤病人之複癌
摘要
頭頸部腫瘤的病人被認爲特別容易有複癌的產生，爲了更加了解這個議題，我們以台大醫院頭頸部腫瘤的病人爲例，探討其複癌的發生情形。經過回溯性的病歷回顧，並參考癌病登記的資料，截至1991年12月止，共有136個病人有複癌的產生，其中有5個病人甚至有三個不同部位的腫瘤。從1977到1991年，台大醫院共有7,475個頭頸部腫瘤的病人，後來98個產生了複癌，發生率約爲1.31%。另外38個病人的第一個腫瘤是在1977年以前診斷出來的。複癌發生時間的中數爲4.58年，最長的間隔時間是29.75年。大部分的病人（136人中有110人）產生複癌爲不同步的。有91個病人（佔66.9%）複癌發生在頭頸部、食道或肺。複癌最多發生在鼻咽癌的病人（136人中有62人），其中60人曾接受過放射線治療；其次是喉癌的病人（136人中有25人），其中16人曾接受放射線治療或術後放射線治療。以上這兩類疾病，複癌最常發生的部位都位於頭頸部。
並列摘要
Patients with cancer of the head and neck have been described to be particularly susceptible to the development of new cancers. To help our understanding of this issue, we evaluated all head and neck patients with multiple primary cancers in National Taiwan University Hospital (NTUH). A retrospective chart review with correlation of cancer registry records showed that second primary malignancies developed in 136 patients till Dec. 1991. Five of them had three separate cancers. Ninety eight of 136 had their first head and neck primary during 1977-1991 among 7,475 patients, providing the occurrence rate of 1.31%. The other 38 patients had their first cancer diagnosed before 1977. The median time to the development of a second malignant tumor was 4.58 years, with a maximum interval of 29.75 years. Most of the patients (110 in 136) developed a second cancer metachronously. A total of 91 (66.9%) patients had their second cancer in the head and neck, esophagus or lung. Second primary malignancies were most commonly associated with nasopharyngeal index tumors (62 in 136), nearly all of which (60 in 62) received radiation therapy; followed by laryngeal cancers (25 in 136), of which 16 had radiation therapy or surgery plus radiation therapy. In both nasopharyngeal and laryngeal index tumor groups, head and neck region was the most common site of multiple primary cancers.
延伸閱讀
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