- 期刊
Treatment OF Nasopharyngeal Carcinoma With Unusual Histological Features
罕見病理組織形態鼻咽癌之治療結果
摘要
目的：分析罕見病理組織型態鼻咽癌的放射治療成果及復發型態。 材料與方法：十五年內（1983-1997）共有九位罕見病理組統型態鼻咽癌之病患於林口長庚紀念醫院放射腫瘤科接受放射治療；其病理組織型態分別為腺樣囊狀上皮癌(adenoid cystic carcinoma) ，佔四位病人；分化不良腺癌(poorly differentiated adenocarcinoma)，佔三位病人；及黏液類上皮癌(mucoepidermoid carcinoma)，佔兩位病人。年齡分布自15至72歲；男、女性病患分佔七、二位。兩位黏液皮癌病人及一位腺樣囊狀上皮癌病人在放射治療前接受手術切除(transpalate excision of tumor )。所有病人皆接受放射治療；鼻咽的放射劑量為6480 cGy至 7280 cGy ；中位劑量(median dose)為7080cGy。 結果：五年及十年的整體存活率分別為44.4%及29.6%；中位存活期為2.73年。共有六位病人(66%)局部復發；治療後至局部復發的時間最短為十二個月，最長為一百一十三個月(中位數為三十三個月)。共有二位病人發生遠處轉移，分別轉移至肺部及肝臟。 結論：罕見病理組織型態之鼻咽癌在臨床上確屬少見；故病例數限制了本研究的代表性。本研究觀察到此族群有相對較多的晚期病患以及放射治療後局部復發，這些特性或可解釋為何罕見病理組織型態鼻咽癌相較於一般鼻咽癌，其存活率較差。
並列摘要
Purpose: To evaluate the treatment results and relapse patterns for nasopharyngeal carcinomas (NPCs) with unusual histological features. Materials and Methods: From Dec 1983 to April 1997, nine cases of carcinoma occur-ring in the nasopharynx, which were characterized by unusual histological presentations, underwent radiotherapy at the Department of Radiation Oncology, Chang Gung Memorial Hospital-Linkou. The histological diagnoses for these patients were adenoid cystic carcinoma (n= 4), poorly differentiated adenocarcinoma (n= 3), and mucoepider-moid carcinoma (n= 2). This group consisted of two females and seven males, with a median age of 41 years (range, 15 to 72). Two patients with mucoepidermoid carcinoma and one with the adenoid cystic variant underwent transpalate excision of the tumor before irradiation. All patients were treated with definite irradiation, with total dose to the nasopharynx ranging from 6480 to 7280 cGy (median, 7080). Results: The five and ten-year overall survival rates, derived using the Kaplan-Meier method, were 44.4% and 29.6%, respectively. Median survival was 2.73 years. Local recurrence occurred for six of the patients (66%). The duration to local recurrence varied from 12 to 113 months, with a median of 33 months. Two patients developed distant metastasis to lung or liver. Conclusion: Nasopharyngeal carcinomas with unusual histological features are rare. As a result, the small number of such cases diagnosed during the study period limited the statistical power of this study. Relatively advanced stage distribution and a greater proportion of local relapse after definite radiotherapy were observed, with these features probably accounting for the poor survival rate for NPC cases which are characterized by unusual histological features.
延伸閱讀
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