Carcinoma in the Pharynx: Nasopharynx, Oropharynx and Hypopharynx

咽部的癌症：鼻咽癌，口咽癌及下咽癌

呂宜興(Yi-Shing Leu) ； 李振川(Jehn-Chuan Lee)

《中華民國癌症醫學會雜誌》 25卷2期 (2009/04) Pp. 102-113

https://doi.org/10.6588/JCOS.2009.25.2.3

摘要

主題：頭頸部癌症顧名思義泛指發生在頭頸部的惡性鱗狀上皮癌，範圍包括顏面、上唇、唾液腺、鼻腔及鼻竇、口腔、咽喉、甲狀腺等區域。咽部是肌肉管狀結構，連結鼻腔和口腔，主要的功能為當作氣體及食物的通道。
方法：依照解剖位置，咽部可以分為鼻咽（鼻腔後方），口咽（口腔後方）及下咽（咽喉後方），我們回溯研究國內外論文及本院存活率比較分析。
結果：本院鼻咽癌以同步化學治療及放射治療的2年存活率為第一期100%、第二期83.0%、第三期87.8%、第四期65.9%、全部鼻咽癌病例統計為80.7%，口咽癌治療原則以同步化學治療及放射治療優先，所有病例2年存活率為69.52%。下咽癌的同步化學治療及放射治療組，2年存活率及無病存活率為43.8%及49.4%，手術且術後合併化學治療及放射治療組2 年存活率及無病存活率為49.4%及50.0%。
結論：頭頸部癌症的發生率、病理組織型態、危險致病因子等，都相當類似，但是在治療方針及治療效果上，這三種咽部癌症則不盡相同。

關鍵字

癌症 ； 鼻咽 ； 口咽 ； 下咽

並列摘要

Objectives: Head and neck cancers consist of a diverse group of malignancies that range from face, lip, salivary glands and sinuses to oral cavity, pharynx, larynx. The pharynx is the continuation of the nose and mouth. It is a muscular tube that continues downwards through the neck and is responsible for the passage of both air (to the larynx, trachea and lungs) and food (to the esophagus and then stomach).
Methods: The pharynx is divided into three different areas based on anatomical location: nasopharynx (behind the nose), oropharynx (behind the mouth), and hypopharynx (behind the larynx). We also reviewed several studies of cancer in pharynx and compared their results with our own clinical data in these papers.
Results: In the data of the head and neck team in Taipei Mackay Memorial Hospital, the 3-year overall survival rates for carcinoma of nasopharynx with concurrent chemoradiation (CCRT) were 100% in stage Ⅰ, 83% in stage Ⅱ, 87.8% in stage Ⅲ, 65.9% in stage Ⅳ and 80.7% in all stages. The 2-year overall survival rate for oropharyngeal carcinoma were 69.52% with treatment policy of preferred CCRT. The 2-year overall and disease free survival rates for hypo-pharyngeal carcinoma were, respectively 43.8% and 49.4% for the CCRT group, 49.4% and 50.0% for the operation plus CCRT group.
Conclusions: Cancers of the head and neck are often considered together because they share many similarities in incidence, cancer type, predisposing factors, pathological features. However, the treatments and prognoses of these three pharyngeal malignancies are quite different.

並列關鍵字

cancer ； nasopharynx ； oropharynx ； hypopharynx