Treatment Outcome in Oropharyngeal Carcinoma-Preliminary Report

初步報告－口咽癌治療結果分析

楊志雍(Chih-Yung Yang) ； 呂宜興(Yi-Shing Leu) ； 李振川(Jehn-Chuan Lee) ； 張義芳(Yi-Fang Chang) ； 黃明哲(Min-Jer Huang) ； 陳裕仁(Yu-Jen Chen) ； 陳虹汶(Hong-Wen Chen) ； 蕭弘道(Hung-Tao Hsiao) ； 劉崇基(Chung-Ji Liu)

《中華民國癌症醫學會雜誌》 24卷1期 (2008/02) Pp. 10-16

https://doi.org/10.6588/JCOS.2008.24.1.2

摘要

目的：口咽癌相對於其他頭頸部癌症而言雖較為少見，但治療的方式卻在近年被熱烈討論。同步執行放射治療及化學治療(Concurrent Chemoradiotherapy CCRT)為頭頸癌新興之治療方式並且已與手術同樣成為第一線治療之選項。本文將分享本院治療口咽癌之經驗。
方法：本研究回溯本院自2002年至2006年診斷並收治之口咽癌之35名患者。統計資料包含年齡、腫瘤位置分期、發病年齡、以及結果並以RECIST方法評估療效。35名病患均直接接受CCRT.治療完畢後半年內每位病患均每月返診追蹤並在之後每三個月接受定期追蹤。
結果：本院於2002年至2006年間口腔癌患者共35人，其中扁桃腺癌共19人、軟顎癌共5人及舌根癌共11人。平均發病年齡為52.16歲，平均追蹤期為29.04月，最初診斷時並無病患發生遠端轉移，其中8名病患化療劑量因受藥物毒性影響而降低，兩年存活率為66.62%，其中各分期之存活率分布自16.67至100%不等。以RECIST法評估療效，共40%之病患腫瘤完全消失，治療後追蹤共3人發現遠端轉移，1人在治療後29個月後發現局部復發，比較減低化療劑量病患之良好反應率與接受正常劑量患者並無顯著差距。
結論：本文提供了本院治療口咽癌之經驗。根據此研究結果發現因副作用而降低化學治療劑量在良好反應率方面並無顯著影響。建議病患如無法承受高劑量化學治療時應適當降低劑量。

關鍵字

鱗狀上皮細胞癌 ； 口咽癌 ； 同步電化療

並列摘要

Purpose: The aim of this study is to assess the result and the effect of concurrent chemoradiotherapy for oropharyngeal carcinoma.
Materials and Methods: A retrospective survey of patients who underwent chemotherapy and radiation for oropharyngeal carcinoma at Mackay Memorial Hospital. Collected data include age, tumor site, therapy protocol and result of the treatment, which is assessed with RECIST method.
Results: Totally 35 patients were diagnosed with oropharyngeal carcinoma during 2002 and 2006; the average age at diagnosis was 52.16 years and the average follow up period was 29.09 months. No distant metastasis was found at diagnosis. Eight patients received decreased chemotherapic dosage due to toxic effect. Overall 2-year survival rate was 66.62% and the survival rate between each stage was ranged from 16.67% to 100%. Complete remission was observed on 14 patients (40.0%). Distant metastasis after treatment was found on 3 patients and local recurrence was found on 1 patient. No significant difference of the well-response rate between the patients who received full dosage of chemotherapy and those who received decreased dosage.
Conclusions: In this article we present the experience for the treatment of the oropharyngeal carcinoma. The suggested policies of management in oropharyngeal carcinoma is concurrent chemoradiation in priority. There is no negative effect in reduced dosage of chemotherapy with less side effect.

並列關鍵字

Squamous cell carcinoma ； oropharyngeal carcinoma ； concurrent chemoradiotherapy