- 期刊
- OpenAccess
The Contemporary Treatment of Hypopharyngeal Cancer: Options for Function Preservation Strategies
摘要
Hypopharyngeal cancer is uncommon. Less than 20% present with early stage disease (T1 ~ 2, N0), when diagnosed can be treated by surgery or radiotherapy with equal favourable survival outcome, and larynxpreservation survival at 3 years of almost 100%. Moderately advanced operable stage disease (Stage III - T1 ~ 3, N0 ~ 2, M0) in the past was treated by primary surgery with post-operative radiotherapy, but most often resulted in the loss of the larynx and replacement of the hypopharynx, achieved ＞ 50% disease control and resulted in a negative impact on quality of life. Currently two treatment options are recommended for moderately advanced operable stages hypopharyngeal cancer with the goal of functional ＂organ preservation＂ -- larynx and pharynx -- which results in comparable loco-regional disease control and survival rates -- transoral or endoscopic laser or robotics surgery or a combination of radiotherapy with chemo(bio)radiotherapy. By employing these options of treatment will limit reduce the need for ＂radical surgery＂ (pharyngolaryngectomy) and should be reserved for patients with persistent or recurrent disease after treatment, a non-functioning larynx or hypopharynx (stenosis or necrosis) resulting from treatment, or advanced volume disease +/- significant functional loss on presentation. Following the introduction of ＂organ preservation＂ strategies, the indications for its usage have expanded to include Stage IVa and IVb disease, as a treatment trial to reverse ＂inoperable disease＂ to ＂operable,＂ and for palliation. The choice of best strategy remains a challenge for clinicians and hence each patient should be evaluated in a multidisciplinary team, choosing the most suitable treatment for that individual patient.
被引用紀錄
延伸閱讀
- Chung, N. N., Ting, L. L., Huang, S. C., Fong, L., Lui, L. T., & Lee, S. Y. (1995). Treatment of Hypopharyngeal Carcinoma: A Retrospective Analysis over a 16-Year Period. 中華放射線醫學雜誌, 20(1), 33-42. https://www.airitilibrary.com/Article/Detail?DocID=10188940-199503-20-1-33-42-a
- Hung, S. K., Chen, H. L., Hsieh, C. H., Hsu, W. L., Chang, K. H., Chen, Y. J., & Lee, M. S. (2006). Concurrent Chemoradiotherapy versus Radiotherapy Alone for Hypopharyngeal Cancer. 中華放射線醫學雜誌, 31(2), 77-84. https://www.airitilibrary.com/Article/Detail?DocID=10188940-200604-31-2-77-84-a
- 呂宜興、張義芳、李振川、蕭弘道、陳裕仁、陳虹汶、孫芳如（2013）。The Impact on Survival after Change of Treatment Modalities in Advanced Hypopharyngeal Cancer。台灣耳鼻喉頭頸外科雜誌，48(1)，87-96。https://doi.org/10.6286/2013.48.1.87
- Chen, H. L., Lee, T. L., & Chu, P. Y. (2014). Changing Trends in Reconstrution after Resection of Hypopharyngeal Carcinoma. 台灣耳鼻喉頭頸外科雜誌, 49(1), 12-20. https://doi.org/10.6286/2014.49.1.12
- Hung, L. C., Liu, M. T., Chen, M. K., Chang, C. C., Huang, C. C., Huang, C. Y., Pi, C. P., Chang, T. H., & Hsu, C. C. (2008). Prognostic Factors Affecting the Outcome of Oropharyngeal Carcinoma. 放射治療與腫瘤學, 15(3), 167-179. https://doi.org/10.6316/TRO/200815(3)167