- 期刊
頰癌之治療－64例之分析
Treatment of Buccal Carcinoma - Analysis of 64 Cases
摘要
馬偕紀念醫院耳鼻喉科自1986年6月至1993年5月止，共有64例頰黏膜扁平細胞癌患者在本科接受完整治療及追蹤。男性61名、女性3名，年齡從36歲至84歲，平均年齡為50.3歲，其中53.1%有喝酒習慣，73.4%有吸煙習慣，78.1%有嚼檳榔習慣，三者皆有佔31.2%。其臨床分期依1992年AJCC的TNM系統為：第一期6例（9.4%）、第二期21例（32.8%）、第三期15例（23.4%）、第四期22例（34.4%）。治療方式以術前化學治療、手術、術後放射治療為主。手術方式為複合切除術（composite resection），若缺損過大則以胸大肌肌皮瓣重建，佔65.6%。治療結果：3年存活率各期分別為80.0%、76.5%、69.2%、61.1%，合計69.8%；5年存活率各期分別為75.0%、50.0%、50.0%、41.7%，合計50.2%；排除非本疾病死亡者，其3年存活率各期分別為100%、81.3%、76.9%、68.8%，合計77.6%；5年存活率各期分別為100.0%、57.1%、57.1%、50.0%，合計59.3%。64例頰癌患者中有15例復發佔23.4%，平均復發時間距治療後11.5個月，其中局部復發7例（10.9%），頸部復發6例（9.4%），遠處轉移2例（3.1%）。復發病例中11例死亡，佔73.3%。
並列摘要
From July 1986 to June 1993, there were 64 patients with buccal carcinoma treated and followed in the ENT department of Mackay Memorial Hospital. They were 64 males and 3 females. Age ranged from 36 to 84 years, with a mean age of 50.3 years. Among them, 74% had the habit of smoking, and 79% had the habit of betel-nut chewing. According to the TNM system of AJCC, there were 6 cases (9.5%) classified as Stage I , 21 cases (32.8%) as Stage Ⅱ, 15 cases (23.4%) as Stage Ш and 22 cases (34.3%) as Stage Ⅳ. The treatment modalities included preoperative chemotherapy, surgery and postoperative radiotherapy. The overall survival rate were 69.8% (3 years) and 50.0% (5 years). Excluding the cases who died from other causes, the overall survival rate were 77.6% (3 years) and 59.3% (5 years) respectively. Among the 64 cases of buccal carcinoma, fifteen showed relapse (23.4%). They were seven local recurrence (10.9%), six neck recurrence (9.4%), and two distant metastasis (3.1%). The average relapsing interval was 11.5 months. Eleven out of fifteen cases died in the following period.