Comparative Analysis of Treatment Result in Advanced Hypopharyngeal Cancer: Chemoradiotherapy Alone or Surgery Followed by Chemoradiotherapy

晚期下咽癌治療分析比較：以單獨同步化學放射治療或是手術合併化學放射治療方式

吳敏夫(Min-Fu Wu) ； 呂宜興(Yi-Shing Leu) ； 李振川(Jehn-Chuan Lee) ； 蕭弘道(Hung-Tao Hsiao) ； 張源清(Yuan-Ching Chang) ； 楊政謙(Cheng-Chien Yang) ； 陳裕仁(Yu-Jen Chen) ； 張義芳(Yi-Fang Chang)

《中華民國癌症醫學會雜誌》 24卷4期 (2008/08) Pp. 236-242

https://doi.org/10.6588/JCOS.2008.24.4.5

摘要

背景：過去在晚期下咽癌的治療上，較常被使用的治療方式是以手術切除、加上術後放射治療。近來以同步執行化學治療合併放射治療，以期保留患者器官的治療方式已漸漸被重視。本回溯性研究即是針對晚期下咽癌，依不同治療方式，提出治療結果之比較。
方法：本研究採病例回溯性分析。自2002年1月至2005年6月間，於馬偕紀念醫院頭頸癌治療團隊診斷為晚期(stage III, IVA, IVB)下咽癌的病人，排除遠處轉移的病患後，累計共28例。其中16例接受合併化學及放射治療（CCRT組），12例接受手術合併術後化學及放射治療（OP+CCRT組）。平均追蹤期間為21個月。
結果：本研究晚期下咽癌患者整體的2年存活率約為46%；CCRT組及OP+CCRT組分別為43.8%及49.4%。而2年無疾病存活率CCRT組為37.5%，OP+CCRT組為50%。皆無統計學上差異。
結論：同步執行化學治療及放射治療，在晚期下咽癌的治療上，是有效且可行的治療方式。

關鍵字

下咽癌 ； 手術 ； 同步化學放射治療

並列摘要

Background: Concomitant chemotherapy and radiotherapy (CCRT) is an alternative, organ preserving way to perform surgery in patients with advanced hypopharyngeal carcinoma. The purpose of this retrospective study was to compare the results of advanced hypopharyngeal carcinoma according to different treatment modalities.
Materials and Methods: Twenty-eight patients with advanced stage as stage III, IVA, IVB of hypopharyngeal carcinoma who were treated by the head and neck team of the cancer center at Mackay Memorial Hospital between January 2002 and June 2005 were retrospectively analyzed. Sixteen patients were treated with concomitant chemotherapy and radiotherapy alone (CCRT group), and 12 patients were treated with surgery and postoperative concomitant chemotherapy and radiotherapy (OP+CCRT group). Median follow-up period was 21 months.
Results: The overall 2-year survival rates were 43.8% for the CCRT group and 49.4% for the OP+CCRT group. The 2-year disease-free survival rates were 37.5% for the CCRT group and 50.0% for the OP+CCRT group. No significant differences were found in overall and disease-free survival rates between the CCRT and OP+CCRT groups (p=.82, p=.57).
Conclusions: Concomitant chemoradiotherapy is an effective strategy to achieve organ preservation without compromising the survival of patients with advanced hypopharyngeal carcinoma. However, this is only a 2-year result; long-term follow-up is needed.

並列關鍵字

hypopharyngeal cancer ； surgery ； concurrent chemoradiotherapy