Five-Year Survival Rate for Squamous Cell Carcinoma of the Anal Canal: A Retrospective Study

肛管鱗狀上皮癌治療後的五年存活率

傅峰梧(Feng-Wu Fu) ； 王輝明(Hwei-Ming Wang) ； 陳周斌(Joe-Bin Chen) ； 陳周誠(Chou-Chen Chen) ； 馬秀峰(Hsiu-Feng Ma) ； 趙德馨(Teshin Chao) ； 蔣鋒帆(Feng-Fan Chiang)

《中華民國大腸直腸外科醫學會雜誌》 16卷3期 (2005/09) Pp. 95-100

https://doi.org/10.6312/SCRSTW.2005.16(3).09413

摘要

目的　單獨使用放射線或合併化學治療，是肛管鱗狀上皮細胞癌的首選治療方式，肛管鱗狀上皮細胞癌之治療自從80年代之後已有了重大的改變，此篇回顧性的研究報告是針對台中榮民總醫院於過去20年之中，治療肛管鱗狀上皮細胞癌的經驗來分析統計整體的五年存活率，並比較有無合併放射線化學治療的病患，其五年存活率的差別。
方法　我們依據病歷記錄及病理報告收集1980年7月到2001年4月之間，選擇33例肛管鱗狀上皮細胞癌的病患進行研究分析。33例肛管鱗狀上皮細胞癌的病人中有25例接受放射線化學化學治療，8例沒接受放射線化學化學治療。放放射化治療的方式包含5-FU（300mg/平方公尺）及mitomycin（10mg/平方公尺）靜脈注射及6000cGy的放射線治療。再依據治療的結果比較二者之間的五年存活率。
結果　在33例病患之中，有25例接受射線化學化治療，8例沒接受射線化學化治療，五年存活率分別為：86%及17%，平均的五年存活率為64%（平均追跡時間80週）。影響治療結果的因素包括(1)病患在射線化學化治療時疾病是否仍持續進行，(2)是否有遠端轉移，(3)是否有血液淋巴轉移，(4)年紀，(5)腫瘤是否超過5公分。
結論　肛管癌症的治療方式有很多種，隨著治療技術的進步，其五年存活率已有明顯的改善，而目前肛管鱗狀上皮細胞癌的標準治療方式應是5-FU合併mitomycin靜脈注射加上放射線治療，因為它的確能達到不錯的五年存活率並且能保留病患的肛門。

關鍵字

存活率 ； 放射線化學治療 ； 肛管 ； 鱗狀上皮細胞癌

並列摘要

Purpose. The therapeutic options of squamous cell carcinoma of anal canal have dramatically changed since 1980. Radiotherapy alone or combined with chemotherapy is the primary therapeutic option. This study was designed to analyze the 5-year survival rate for squamous cell carcinoma of the anal canal treated with or without chemoradiation.
Methods. We retrospectively reviewed the medical records of 33 squamous cell carcinoma of anal canal patients, who were treated from July, 1980 to April, 2001 at Taichung Veterans General Hospital. Among these, 25 patients did and 8 did not undergo chemoradiation. The treatment consisted of 5-FU and mitomycin intravenous injection followed by radiation of 6000 cGy to the pelvic and perianal area over 5.5 weeks. Data were reviewed and analyzed with regard to treatment, outcome and prognostic factors.
Results. The 5-year survival rate was 86% for the 25 patients treated with chemoradiation and 17% for the 8 patients did not receive chemoradiation, respectively. The mean 5-year survival rate of the 33 patients was 64%. The predictors that decrease survival rate in the subgroup of 25 patients included: disease persistence after chemoradiation, nodal disease, tumor size larger than 5cm and age.
Conclusions. Radiation combined with 5-FU and mitomycin intravenous injection remains the treatment of choice in most patients with squamous cell carcinoma of the anal canal and it provides a relatively satisfactory survival rate.

並列關鍵字

Chemoradiation ； Survival rate ； Squamous cell carcinoma ； Anal canal